Emergency visit, moderate (level 3) at HSHS St. Mary's Hospital Medical Center. CPT 99283.

What HSHS St. Mary's Hospital Medical Center publishes for this service, straight from its standard-charges file, last updated March 24, 2026.

Outpatient / ER

$840cash price (self-pay)

$1,272list price

$267–$1,272range insurers pay

Insurance plan	Negotiated rate
Aetna \| Aetna Medicare	$267
Anthem \| Anthem Medicare Advantage HMO	$267
Humana \| Humana Medicare Advantage	$267
Medicare Managed \| Managed Medicare No Sequestration	$267
Molina Healthcare \| Molina Medicare	$267
United Healthcare \| United Health Care Medicare	$267
Security Health Plan \| Medicare Advantage Security Health Plan Of Wi	$269
Naphcare \| All Commerical Naphcare	$600
Hshs Employees \| Hshs Employees	$618
Molina Healthcare Of Wi \| All Commerical Molina Marketplace	$636
Security Health Plan \| All Commercial Security Health Plan Broad Netwo	$812
Cigna \| All Commercial Cigna	$890
Health Eos \| All Commercial Health Eos	$903
Triology \| All Commercial Triology	$916
Healthsmart \| All Commercial Healthsmart	$929
Interplan \| All Commercial Interplan Health Group	$929
Network Health Plan \| All Commerical Network Health Plan	$954
Health Care Alliance \| The Alliance	$1,068
Multiplan/Phcs \| All Commercial Multiplan	$1,068
Choicecare \| All Commercial Choice Care	$1,081
Humana \| All Commercial Humana Hpn Choicecare	$1,081
Humana \| Humana Choice Care PPO	$1,081
North Central Healthcare Alliance \| Neha	$1,170
First Health \| All Commercial First Health Network	$1,208
Aetna \| Aetna Hshs	$1,272
Aetna \| All Commercial Aetna	$1,272
Anthem \| Anthem POS/HMO	$1,272
Anthem \| Anthem PPO	$1,272
Caterpillar, Inc. \| UHC Caterpillar Employer Group	$1,272
Cenpatico \| All Medicaid Cenpatico	$1,272

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