Emergency visit, moderate (level 3) at Henry Ford St John Hospital. CPT 99283.
What Henry Ford St John Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$517cash price (self-pay)
$1,016list price
$69.18–$740range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ahlic | 2163_ahlic 20241001 | $69.18 |
| Hap HMO | 2166_health Alliance HMO 20241001 | $69.18 |
| Hap HMO | 2174_sjma Health Alliance HMO 20241001 | $69.18 |
| Meridian Health Plan | 1945_medicaid Replacement Meridian Health Outpa | $103 |
| Ppom | 934_ppom 20191001 | $140 |
| Tricare | 2211_tricare Op 20250101 | $271 |
| Meridian Wellcare | 2210_medicare Advantage Meridian Wellcare Outpatie | $285 |
| Aetna PPO | 2136_aetna 20241001 | $732 |
| Hap Preferred | 2171_hap Preferred (Php) 20241001 | $740 |
Inpatient
—cash price (self-pay)
—list price
$258–$515range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare Pace | 2278_sjmc Sjma Pace Medicare Inpatient 20251001 | $258 |
| Amerihealth Vip Care | 2273_medicare Advantage Amerihealth Vip Care In | $269 |
| Aetna Better Health | 2272_medicare Advantage Aetna Better Health Inpa | $271 |
| Harbor Advantage HMO | 2274_medicare Advantage Harbor Advantage HMO In | $271 |
| Medicare Replacement | 2279_medicare Advantage Blue Cross Network Conn | $271 |
| Tricare | 480_tricare Ip 20170101 | $271 |
| Veterans Choice | 2283_veterans Choice Ip 20251001 | $271 |
| Humana Mcr | 2275_medicare Advantage Humana Inpatient 20251001 | $274 |
| Mclaren Medicare Advantage HMO | 2276_medicare Advantage Mclaren Inpat | $285 |
| Meridian Wellcare | 2280_medicare Advantage Meridian Wellcare Inpatien | $285 |
| Molina Advantage | 2281_medicare Advantage Molina Inpatient 20251001 | $285 |
| Molina Health Link | 2282_medicare Advantage Molina Health Link Inpati | $285 |
| Meridian Ambetter | 2286_medicare Advantage Meridian Ambetter Inpatien | $339 |
| Molina Market Place | 2287_molina Marketplace Inpatient 20251001 | $339 |
| Smarthealth | 2284_smarthealth Inpatient 20251001 | $380 |
| Aaa-Auto Insurance | 2285_aaa-Auto Insurance Inpatient 20251001 | $515 |
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