Emergency visit, high (level 4) at Ascension Calumet Hospital. CPT 99284.
What Ascension Calumet Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$656cash price (self-pay)
$1,168list price
$126–$2,890range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Connection | 999_anthem Blue Connection Mewi Sewi 20230401 | $126 |
| Anthem HMO POS | 1000_anthem HMO POS Mewi Sewi 20230401 | $126 |
| Anthem Pathways | 946_anthem Pathways Mewi Sewi 20230101 | $126 |
| Anthem PPO | 1001_anthem PPO Mewi Sewi 20230401 | $126 |
| Centivo Nw1 | 892_centivo Nw1 Mewi Sewi 20221001 | $259 |
| Centivo Nw3 | 1013_centivo Nw3 Mewi Sewi 20221001 | $259 |
| Aca | 909_network Health Plan Aca Mewi Sewi 20221001 | $1,442 |
| United Health Care POS | 985_united Health Care POS Mewi Sewi 20230401 | $2,246 |
| Network Health Plan | 938_network Health Plan Mewi Sewi 20230101 | $2,563 |
| Alliance | 885_alliance Mewi Sewi 20221001 | $2,567 |
| Cchp | 931_cchp Mewi Sewi 20230101 | $2,793 |
| Sehn | 895_sehn Mewi Sewi 20221001 | $2,890 |
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