Emergency visit, highest (level 5) at SSM Health St. Agnes Hospital - Fond du Lac. CPT 99285.
What SSM Health St. Agnes Hospital - Fond du Lac publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$523cash price (self-pay)
$1,755list price
$442–$1,137range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| MOLINA | Medicare Managed Care Plan | $442 |
| BCBS | Anthem Medicare Managed Care Plan | $589 |
| Wellcare | Medicare Managed Care Plan | $601 |
| DOC | Government | $1,137 |
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All common services at SSM Health St. Agnes Hospital - Fond du Lac