Emergency visit, high (level 4) at Froedtert West Bend Hospital. CPT 99284.
What Froedtert West Bend Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$791cash price (self-pay)
$1,665list price
$413–$5,359range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Allwell | Medicare Advantage | $413 |
| Anthem Blue Cross Blue Shield | Medicare Advantage | $413 |
| Community Care | Medicare Advantage | $413 |
| Health Partners | Medicare Advantage | $413 |
| Humana | Medicare Advantage | $413 |
| ICare | Medicare Advantage | $413 |
| Molina | Medicare Advantage | $413 |
| Network Health Plan | Medicare Advantage | $413 |
| Security Health Plan Secure Savers | Medicare Advantage | $413 |
| United Healthcare | Medicare Advantage | $413 |
| Aetna | Medicare Advantage | $422 |
| Care Wisconsin | Medicare Advantage | $426 |
| UMR | MCW Employees | $549 |
| Centivo | WI 2 Median | $699 |
| Froedtert South | All Contracted Commercial Plans | $699 |
| Chorus Community Health Plan | All Contracted Commercial Plans | $716 |
| Centivo | WI 1 Broad | $799 |
| Common Ground | All Contracted Commercial Plans | $999 |
| Health Payment Systems | Group Specific | $1,048 |
| Health Partners | All Contracted Commercial Plans | $1,082 |
| Aetna | All Contracted Commercial Plans | $1,165 |
| Wisconsin Physician Services | All Contracted Commercial Plans | $1,332 |
| Health Payment Systems | Other Commercial Plans | $1,346 |
| Trilogy | All Contracted Commercial Plans | $1,365 |
| Anthem Blue Cross Blue Shield | PPO | $1,415 |
| Americas Choice | PPO | $1,448 |
| HealthEos | All Contracted Commercial Plans | $1,448 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $1,448 |
| First Health Network | All Contracted Commercial Plans | $1,465 |
| Hfn | PPO | $1,498 |
Inpatient
$791cash price (self-pay)
$1,665list price
$863–$1,796range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Common Ground | All Contracted Commercial Plans | $999 |
| Health Payment Systems | Group Specific | $1,048 |
| Aetna | All Contracted Commercial Plans | $1,165 |
| Health Payment Systems | Other Commercial Plans | $1,346 |
| Trilogy | All Contracted Commercial Plans | $1,365 |
| Americas Choice | PPO | $1,448 |
| HealthEos | All Contracted Commercial Plans | $1,448 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $1,448 |
| First Health Network | All Contracted Commercial Plans | $1,465 |
| Hfn | PPO | $1,498 |
| IBSI Passport | All Contracted Commercial Plans | $1,498 |
| Cigna | All Contracted Commercial Plans | $1,581 |
| HealthSmart | All Contracted Commercial Plans | $1,581 |
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