Emergency visit, high (level 4) at Lonesome Pine Hospital. CPT 99284.
What Lonesome Pine Hospital publishes for this service, straight from its standard-charges file, last updated March 23, 2026.
Outpatient / ER
$300cash price (self-pay)
$2,002list price
$50.00–$2,002range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare | Tenncare United Healthcare | $50.00 |
| Aetna | Aetna Healthcare Medicare | $407 |
| Allcare Medicare | Allcare Medicare | $407 |
| Amerigroup | Amerigroup Medicare Wellpoint | $407 |
| Humana | Humana Medicare | $407 |
| Managed Medicaire | Managed Medicaire | $407 |
| Sentara Health | Sentara Medicare | $407 |
| United Healthcare | United Healthcare Medicare | $407 |
| United Mine Workers Of America | United Mine Workers Of America | $407 |
| Aetna | Aetna Better Health Of Virginia Medicare | $419 |
| Blue Cross | Anthem Medicare Virginia | $419 |
| Blue Cross | Blue Cross Medicare | $423 |
| Cigna Healthcare | Cigna Medicare | $427 |
| Devoted Health Plan | Devoted Health Plan Medicare | $427 |
| Molina Healthcare | Molina Healthcare Medicare | $427 |
| Mountain Empire Pace | Mountain Empire Pace | $427 |
| Nhc Advantage | Nhc Advantage | $427 |
| Wellcare | Wellcare Medicare | $432 |
| Sentara Health | Sentara Health | $507 |
| Blue Cross | Blue Cross Ballad Health Employee | $806 |
| Aetna | Aetna | $855 |
| Ambetter | Ambetter | $888 |
| Medcost | Medcost Vhn | $953 |
| Seven Corners, Inc. | Seven Corners, Inc. | $977 |
| Blue Cross | Anthem Exchange | $1,342 |
| United Healthcare | UHC Heritage Select | $1,528 |
| Blue Cross | Anthem HMO | $1,557 |
| United Healthcare | UHC Heritage River Valley | $1,597 |
| Blue Cross | Blue Cross P Network | $1,657 |
| Blue Cross | Blue Cross S Network | $1,657 |
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