Emergency visit, high (level 4) at Holland Hospital. CPT 99284.
What Holland Hospital publishes for this service, straight from its standard-charges file, last updated September 21, 2026.
Outpatient / ER
$121cash price (self-pay)
$203list price
$50.00–$2,368range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $50.00 |
| Ph Mcaid | Ph Mcaid | $76.68 |
| UHC Mcaid | UHC Mcaid | $76.68 |
| Molina Mcaid - All Plans | Molina Mcaid - All Plans | $76.68 |
| Meridian Mcaid Profee Only-All Plans | Meridian Mcaid Profee Only-All | $76.68 |
| Nomi Health - All Plans | Nomi Health - All Plans | $84.00 |
| Life Circles-All Plans | Life Circles-All Plans | $113 |
| UHC Mcr Adv | UHC Mcr Adv | $118 |
| Health Alliance Mcr Adv | Health Alliance Mcr Adv | $118 |
| Ph Mcr Adv | Ph Mcr Adv | $118 |
| Va Ccn - All Plans | Va Ccn - All Plans | $118 |
| Aetna Mcr Adv | Aetna Mcr Adv | $122 |
| Longevity Health Plan-All Plans | Longevity Health Plan-All Plans | $128 |
| Aetna Existing Bus - All Other Plans | Aetna Existing Bus - All Other | $152 |
| Aetna New Bus | Aetna New Bus | $152 |
| Cofinity -All Plans | Cofinity -All Plans | $152 |
| First Health-All Plans | First Health-All Plans | $154 |
| Blue Care Network - All Plans | Blue Care Network - All Plans | $179 |
| BCBS - All Plans | BCBS - All Plans | $192 |
| Cigna - All Plans | Cigna - All Plans | $193 |
| Priority Health - All Other Plans | Priority Health - All Other Plans | $203 |
| Sisco-All Other Plans | Sisco-All Other Plans | $214 |
| Benefit Source Inc-All Plans | Benefit Source Inc-All Plans | $221 |
| Multiplan - All Plans | Multiplan - All Plans | $225 |
| Health Alliance HMO | Health Alliance HMO | $240 |
| Asr - All Plans | Asr - All Plans | $240 |
| Health Alliance Ahl - All Other Plans | Health Alliance Ahl - All Othe | $240 |
| Sisco Epi | Sisco Epi | $349 |
| Usa Managed Care-All Plans | Usa Managed Care-All Plans | $775 |
| Integrated Health Plans-All Plans | Integrated Health Plans-All Plans | $818 |
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