Emergency visit, highest (level 5) at Gundersen TriCounty Hospital and Clinics. CPT 99285.
What Gundersen TriCounty Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$1,078cash price (self-pay)
$1,701list price
$720–$4,286range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Products | $720 |
| Quartz | All Other Self Funded | $748 |
| Quartz | Self Funded | $799 |
| Quartz | Level Funded | $825 |
| UCARE | Non-Dually Eligible | $885 |
| UCARE | MSHO/Minnesota Special Needs | $885 |
| UCARE | Dually Eligible | $885 |
| Quartz | Fully Insured | $927 |
| Anthem | Medicare HMO/PPO | $1,004 |
| Humana | Medicare Advantage | $1,004 |
| Quartz | Medicare Advantage | $1,004 |
| UHC | Medicare Advantage | $1,004 |
| UHC | All Payer Appendix | $1,225 |
| Cigna | All Products | $1,311 |
| Alliance | Premier/All Products | $1,329 |
| Alliance | Comprehensive/All Products | $1,335 |
| Group Health of South Central | All Products | $1,361 |
| Trilogy | All Products | $1,361 |
| UCARE | Qualified Health Plan | $1,361 |
| Aspirus Arise Health | All Products | $1,412 |
| Allied National | Core Value Programs | $1,446 |
| Sana | All Products | $1,463 |
| Group Health Eau Claire | All Products | $1,531 |
| Coventry Health Care | All Products | $1,616 |
| WPS | All Products | $1,616 |
| WPS - ARISE | All Products | $1,616 |
| Anthem | State Specific | $3,490 |
| Anthem | HMO/POS | $3,490 |
| Anthem | PPO | $4,286 |
Inpatient
$1,078cash price (self-pay)
$1,701list price
$720–$1,616range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $1,002 |
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All common services at Gundersen TriCounty Hospital and Clinics