Emergency visit, high (level 4) at UnityPoint Health - Trinity Moline. CPT 99284.
What UnityPoint Health - Trinity Moline publishes for this service, straight from its standard-charges file, last updated January 28, 2026.
Outpatient / ER
$44.00cash price (self-pay)
$276list price
$21.67–$3,528range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark Blue Cross and Blue Shield | HMO | $198 |
| Cigna/Midlands | Commercial | $233 |
| Medica Exchange Inspire | Commercial | $266 |
| Medica Exchange Insure | Commercial | $298 |
| Iowa Total Care | Managed Medicaid | $331 |
| BC Illinois Community | MMAI (Medicare-Medicaid) | $417 |
| Blue Cross and Blue Shield | Medicare Advantage | $444 |
| Aetna | Medicare Advantage | $453 |
| Health Alliance | Medicare Advantage | $453 |
| Wellmark Blue Cross and Blue Shield | Medicare Advantage | $453 |
| Molina Medicare Options & Molina | MMAI Medicare Advantage | $453 |
| Humana | Medicare Advantage | $466 |
| Meridian Health Plan | Medicare Advantage | $466 |
| United Healthcare | Medicare Advantage | $466 |
| Amerivantage | Medicare Advantage | $466 |
| Health Partners Open Network | Commercial | $619 |
| Ambetter | HMO | $710 |
| Aetna | HMO | $1,074 |
| United Healthcare | HMO | $1,117 |
| United Healthcare | PPO | $1,117 |
| Aetna | PPO | $1,208 |
| Blue Cross and Blue Shield | POS | $3,072 |
| Blue Cross and Blue Shield | PPO | $3,528 |
| Wellmark UPH Self-Funded | Commercial | $3,528 |
Inpatient
$44.00cash price (self-pay)
$676list price
$28.99–$683range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna/Midlands | Commercial | $356 |
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