Providence St Mary Medical Center — ER visit prices
← Hospital overviewVerified from Providence St Mary Medical Center’s published price file
Includes cash prices, list prices. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
6 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC ED FAC E&M VISIT LEVEL 1 CDM Inpatient & outpatient | 99281 HCPCS | $500 | $350 | — | — | |
| HC ED FAC E&M VISIT LEVEL 2 CDM Inpatient & outpatient | 99282 HCPCS | $835 | $585 | — | — | |
| HC ED FAC E&M VISIT LEVEL 3 CDM Inpatient & outpatient | 99283 HCPCS | $1,450 | $1,015 | — | — | |
| HC ED FAC E&M VISIT LEVEL 4 CDM Inpatient & outpatient | 99284 HCPCS | $2,303 | $1,612 | — | — | |
| HC ED FAC E&M VISIT LEVEL 5 CDM Inpatient & outpatient | 99285 HCPCS | $3,226 | $2,258 | — | — | |
| HC ED SEXUAL ASSAULT EXAM CDM Inpatient & outpatient | 99284 HCPCS | $2,303 | $1,612 | — | — |