Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
VISIT ER IV W/25
Smithville, TX
See all hospitals reporting CPT 99284 →Price type
Ascension Seton’s median price of $355 is 44% below the median hospital's median price ($629), higher than 13% of the 2,555 hospitals reporting CPT 99284. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 58 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Superior Healthplan 3509_chirp superior star (chi,dcn) inpatient 20240901 case rate · both | $200.00 | $200.00 | $200.00 – $200.00 |
| 2 | Superior Healthplan 3515_chirp superior star (smv) inpatient 20240901 case rate · both | $200.00 | $200.00 | $200.00 – $200.00 |
| 3 | Superior Healthplan 4241_chirp superior star (chi,dcn) outpatient 20241201 case rate · outpatient | $200.00 | $200.00 | $200.00 – $200.00 |
| 4 | Superior Healthplan 4247_chirp superior star (smv) outpatient 20241201 case rate · outpatient | $200.00 | $200.00 | $200.00 – $200.00 |
| 5 | Superior Healthplan 4375_chirp superior star plus (chi,dcn) inpatient 20240901 case rate · both | $200.00 | $200.00 | $200.00 – $200.00 |
| 6 | Superior Healthplan 4381_chirp superior star plus (smv) inpatient 20240901 case rate · both | $200.00 | $200.00 | $200.00 – $200.00 |
| 7 | Superior Healthplan 4389_chirp superior star plus (chi,dcn) outpatient 20241201 case rate · outpatient | $200.00 | $200.00 | $200.00 – $200.00 |
| 8 | Superior Healthplan 4401_chirp superior star plus (smv) outpatient 20241201 case rate · outpatient | $200.00 | $200.00 | $200.00 – $200.00 |
| 9 | Blue Cross Blue Shield 4174_blue cross chip (smv) outpatient 20241201 fee schedule · outpatient | $263.35 | $259.33 | $211.98 – $280.80 |
| 10 | Blue Cross Blue Shield 4174_blue cross chip/star kids (smv) outpatient 20241201 fee schedule · outpatient | $263.35 | $259.33 | $211.98 – $280.80 |
| 11 | Blue Cross Blue Shield 4225_chirp blue cross star (smv) outpatient 20241201 fee schedule · outpatient | $263.35 | $259.33 | $211.98 – $280.80 |
| 12 | Blue Cross Blue Shield 5015_blue cross star kids (smv) outpatient 20241201 fee schedule · outpatient | $263.35 | $259.33 | $211.98 – $280.80 |
| 13 | UnitedHealthcare 4259_chirp uhc star (smv) outpatient 20241201 fee schedule · outpatient | $263.35 | $259.33 | $211.98 – $280.80 |
| 14 | UnitedHealthcare 4270_chirp uhc star plus (smv) outpatient 20241201 fee schedule · outpatient | $263.35 | $259.33 | $211.98 – $280.80 |
| 15 | UnitedHealthcare 4317_uhc star kids (smv) outpatient 20241201 fee schedule · outpatient | $263.35 | $259.33 | $211.98 – $280.80 |
| 16 | Tricare 1229_tricare cah outpatient 20170101 case rate · outpatient | $315.92 | $315.92 | $315.92 – $315.92 |
| 17 | Blue Cross Blue Shield 3600_blue cross chip/star kids (smv) inpatient 20240901 fee schedule · both | $329.18 | $324.16 | $264.98 – $351.00 |
| 18 | Blue Cross Blue Shield 3699_chirp blue cross star (smv) inpatient 20240901 fee schedule · both | $329.18 | $324.16 | $264.98 – $351.00 |
| 19 | UnitedHealthcare 3743_chirp uhc star (smv) inpatient 20240901 fee schedule · both | $329.18 | $324.16 | $264.98 – $351.00 |
| 20 | UnitedHealthcare 3754_chirp uhc star plus (smv) inpatient 20240901 fee schedule · both | $329.18 | $324.16 | $264.98 – $351.00 |
| 21 | UnitedHealthcare 4328_uhc star kids (smv) inpatient 20240901 fee schedule · both | $329.18 | $324.16 | $264.98 – $351.00 |
| 22 | Ambetter 3879_superior ambetter (chi,dcn) inpatient 20240901 case rate · both | $347.57 | $347.57 | $347.57 – $347.57 |
| 23 | Ambetter 3880_superior ambetter (chi,dcn) outpatient 20240901 case rate · both | $347.57 | $347.57 | $347.57 – $347.57 |
| 24 | Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 fee schedule · outpatient | $434.37 | $419.51 | $354.53 – $469.62 |
| 25 | Blue Cross Blue Shield 3594_blue cross chip/star kids (chi,dcn) inpatient 20240901 fee schedule · both | $440.44 | $433.72 | $354.53 – $469.63 |
Last updated: Jan 1, 2026
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