Emergency visit, high (level 4) at Summit Pacific Medical Center. CPT 99284.
What Summit Pacific Medical Center publishes for this service, straight from its standard-charges file, last updated August 31, 2026.
Outpatient / ER
$453cash price (self-pay)
$2,196list price
$68.22–$1,976range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Chpw Chip | Chpw Chip | $288 |
| Chpw Healthy Options | Chpw Healthy Options | $288 |
| Chpw Basic Hp | Chpw Basic Hp | $288 |
| Amerigroup Mcaid - All Plans | Amerigroup Mcaid - All Plans | $317 |
| Triwest - All Plans | Triwest - All Plans | $333 |
| Regence Bs Mcr Adv - All Plans | Regence Bs Mcr Adv - All Plans | $334 |
| Chpw Mcr Adv | Chpw Mcr Adv | $341 |
| Wellcare Mcr Adv - All Plans | Wellcare Mcr Adv - All Plans | $353 |
| Chpw Pebb - All Other Plans | Chpw Pebb - All Other Plans | $830 |
| UHC All Payer - All Plans | UHC All Payer - All Plans | $1,015 |
| Cigna - All Plans | Cigna - All Plans | $1,757 |
| First Choice - All Plans | First Choice - All Plans | $1,757 |
| Aetna Comm - All Plans | Aetna Comm - All Plans | $1,976 |
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