Emergency visit, high (level 4) at Aspirus Divine Savior Hospital. CPT 99284.
What Aspirus Divine Savior Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$437cash price (self-pay)
$672list price
$41.89–$3,040range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Group Health Cooperative Of Eau Claire | Group Health Cooperative Comm | $41.89 |
| Group Health Cooperative Of South Central Wisconsin | Group Health Wis | $45.63 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Wisconsin Medicaid Pl | $55.86 |
| Dean Health Plan | Dean Health Plan Wisconsin Medicaid Plans | $55.86 |
| Group Health Cooperative Of Eau Claire | Group Health Wisconsin Medica | $55.86 |
| Multiplan, Inc | Phcs Ppo Networks | $57.54 |
| Aspirus Health Plan, Inc. | Aspirus Health Plan Medicare Advantage | $92.34 |
| Humana | Humana Medicare Ppo/Pos/Hmo Network Plans | $93.49 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Medicare Advantage Pl | $94.20 |
| Dean Health Plan | Dean Health Plan Medicare Advantage | $94.20 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Mediblue Dual Hmo Snp | $94.36 |
| Security Health Plan Of Wisconsin, Inc. | Security Health Plan Wiscons | $95.12 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Mediblue Plus Hmo | $95.36 |
| Managed Health Services Insurance Corp. | Managed Health Wisconsin Med | $95.67 |
| Dean Health Plan | Dean Health Plan Commercial Pos | $202 |
| Dean Health Plan | Dean Health Plan Commercial Hmo | $231 |
| Dean Health Plan | Dean Health Plan Commercial Ppo | $231 |
| First Health Group Corp | First Health National Rental Ppo Network | $238 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Mediblue Access Ppo | $253 |
| Aspirus Health Plan, Inc. | Aspirus Health Plan Hmo/Pos | $337 |
| Quartz Health Solutions, Inc. | Quartz Fully Insured And Self Insured | $340 |
| Multiplan, Inc | Aetna Health Plan Ppo Networks | $368 |
| Forest County Potowatomi | Forest County Potowatomi Aspirus Network Pl | $374 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Blue Preferred Pos | $400 |
| Group Health Cooperative Of South Central Wisconsin | Group Health Coo | $401 |
| Multiplan, Inc | Health Eos Ppos Network Plans | $401 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Blue Traditional Netw | $420 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Federal Employee Prog | $420 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Blue Preferred Hmo | $440 |
| Aetna | Medicare Advantage Esa | $445 |
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