Emergency visit, high (level 4) at Chelsea Hospital. CPT 99284.
What Chelsea Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$40.48cash price (self-pay)
$4,089list price
$1.94–$8,158range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicaid | Molina Medicaid | $238 |
| Caresource | Hap HMO | $313 |
| Blue Care Network Advantage | Bcn Medicare Advantage | $409 |
| Blue Cross - Mi Medicare Advantage | BCBS Medicare Advantage | $409 |
| Molina Medicare Advantage | Molina Medicare Advantage | $409 |
| Hap Medicare Advantage | Hap Medicare Advantage | $409 |
| Priority Health Medicare Advantage | Priority Health Medicare Advantag | $409 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $409 |
| Longevity Ipa Of Michigan LLC Health Plan Isnp | Longevity Ipa Medicar | $470 |
| Wellpath | Wellpath | $647 |
| Vitalcore | Vitalcore Physicians Group | $647 |
| Blue Care Network | Bcn HMO | $665 |
| Blue Cross - La | BCBS Trad / Trust | $665 |
| Blue Cross - Ia (Wellmark) | BCBS Trad / Trust | $665 |
| Blue Cross - Md (Carefirst) | BCBS Trad / Trust | $665 |
| Blue Cross - Me (Anthem) | BCBS Trad / Trust | $665 |
| Blue Cross - Ms | BCBS Trad / Trust | $665 |
| Blue Cross - MA | BCBS Trad / Trust | $665 |
| Blue Cross - Nv (Anthem) | BCBS Trad / Trust | $665 |
| Blue Cross - Mt | BCBS Trad / Trust | $665 |
| Blue Cross - Nj (Horizon) | BCBS Trad / Trust | $665 |
| Asrm - Reliance Standard Life Insurance | Multiplan | $1,469 |
| Christian Care Ministry | Multiplan | $1,469 |
| Dean Health | Multiplan | $1,469 |
| Family Life Insurance Company | Multiplan | $1,469 |
| Allied National Global Care | Multiplan | $1,469 |
| Pai | Multiplan | $1,469 |
| Pan-American Life | Multiplan | $1,469 |
| Multiplan | Multiplan | $1,469 |
| Mvp | Multiplan | $1,469 |
Inpatient
$40.48cash price (self-pay)
$40.48list price
$6.48–$240range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid - Mi | Medicaid | $44.48 |
| Huron Valley Pace Medicaid | Medicaid | $44.48 |
| Medicaid - La | Medicaid | $44.48 |
| Medicaid - MA | Medicaid | $44.48 |
| Medicaid - Md | Medicaid | $44.48 |
| Medicaid - Ms | Medicaid | $44.48 |
| Molina Centennial Care | Medicaid | $44.48 |
| Prestige Health Choice | Medicaid | $44.48 |
| Managed Health Services - Indiana | Medicaid | $44.48 |
| Highmark Wholecare Medicaid | Medicaid | $44.48 |
| Dscc | Medicaid | $44.48 |
| Massachusetts Behavioral Health Partnership | Medicaid | $44.48 |
| Health New England Medicaid Advantage | Medicaid | $44.48 |
| Medicaid - Az | Medicaid | $44.48 |
| Medicaid - Ar | Medicaid | $44.48 |
| Medicaid - Co | Medicaid | $44.48 |
| Medicaid - In | Medicaid | $44.48 |
| Amish Mennonite | Medicaid | $44.48 |
| Upper Peninsula Health Plan (Uphp) Medicaid | Medicaid | $44.48 |
| Metroplus Medicaid Advantage | Medicaid | $44.48 |
| Wi Womens Wellness | Medicaid | $44.48 |
| Buckeye Health Plan Medicaid Advantage | Medicaid | $44.48 |
| Rx Allwin | Medicare | $62.23 |
| Harvard Pilgrim Medicare | Medicare | $62.23 |
| Wellpoint Medicare Advantage | Medicare | $62.23 |
| Imperial Health Plan Medicare Advantage | Medicare | $62.23 |
| Selecthealth Medicare Advantage | Medicare | $62.23 |
| Blue Cross - Ga (Anthem) Medicare Advantage | Medicare | $62.23 |
| Um Health Advantage | Medicare | $62.23 |
| Aurora Special Needs | Medicare | $62.23 |
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