Emergency visit, moderate (level 3) at Gundersen TriCounty Hospital and Clinics. CPT 99283.
What Gundersen TriCounty Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$443cash price (self-pay)
$699list price
$296–$1,142range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Products | $296 |
| Quartz | All Other Self Funded | $308 |
| Quartz | Self Funded | $329 |
| Quartz | Level Funded | $339 |
| UCARE | Non-Dually Eligible | $363 |
| UCARE | MSHO/Minnesota Special Needs | $363 |
| UCARE | Dually Eligible | $363 |
| Quartz | Fully Insured | $381 |
| Anthem | Medicare HMO/PPO | $412 |
| Humana | Medicare Advantage | $412 |
| Quartz | Medicare Advantage | $412 |
| UHC | Medicare Advantage | $412 |
| UHC | All Payer Appendix | $503 |
| Cigna | All Products | $539 |
| Alliance | Premier/All Products | $546 |
| Alliance | Comprehensive/All Products | $549 |
| Group Health of South Central | All Products | $559 |
| Trilogy | All Products | $559 |
| UCARE | Qualified Health Plan | $559 |
| Aspirus Arise Health | All Products | $580 |
| Allied National | Core Value Programs | $594 |
| Sana | All Products | $601 |
| Group Health Eau Claire | All Products | $629 |
| Coventry Health Care | All Products | $664 |
| WPS | All Products | $664 |
| WPS - ARISE | All Products | $664 |
| Anthem | State Specific | $931 |
| Anthem | HMO/POS | $931 |
| Anthem | PPO | $1,142 |
Inpatient
$443cash price (self-pay)
$699list price
$296–$664range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $412 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at Gundersen TriCounty Hospital and Clinics