Emergency visit, high (level 4) at Black River Memorial Hospital. CPT 99284.
What Black River Memorial Hospital publishes for this service, straight from its standard-charges file, last updated January 8, 2026.
Outpatient / ER
$731cash price (self-pay)
$812list price
$32.99–$4,800range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem BCBS | Medicaid | $43.35 |
| Group Health Cooperative of Eau Claire | Medicaid | $43.35 |
| My Choice Wisconsin, Inc. | Medicaid SSI | $43.35 |
| Quartz Health Solutions, Inc | Medicaid/BadgerCare | $43.35 |
| United Health Care | Medicaid | $43.35 |
| My Choice Wisconsin, Inc. | Family Care / Family Care Partnership - Me | $45.63 |
| Humana | Medicare Advantage | $419 |
| Anthem BCBS | Medicare Advantage | $419 |
| My Choice Wisconsin, Inc. | Medicare Dual Advantage | $419 |
| Quartz Health Solutions, Inc | Senior Preferred | $419 |
| Security Health Plan | Badgercare Plus | $419 |
| Security Health Plan | Medicare Advantage | $419 |
| Corvel | Automobile liability / Accident & Health | $501 |
| Corvel | Workers' Compensation | $501 |
| Security Health Plan | EPO | $688 |
| The Alliance | Worker's Compensation | $698 |
| Triology Health Solutions | Health Plan | $739 |
| Quartz Health Solutions, Inc | Commercial / Self-Insured | $747 |
| Humana | Commercial | $764 |
| The Alliance | Health Plan | $764 |
| Medica | Health Plan | $767 |
| Security Health Plan | Commercial | $767 |
| Association Benefits Solution | Health Plan | $780 |
| First Health Group Corporation | MultiPlan PPC Network | $780 |
| Provider Network of America | Health Plan | $780 |
| Triology Health Solutions | Workers Compensation | $780 |
| Family Health Center of Marshfield | Health Plan | $780 |
| United Health Care | Commercial | $788 |
| Cofinity | Cofinity Health Plan | $796 |
| Connecticut General Life Insurance Company (CIGNA) | Health Plan | $796 |
Inpatient
$739cash price (self-pay)
$834list price
$419–$838range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| The Alliance | Health Plan | $800 |
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