Emergency visit, high (level 4) at Trinity Health Grand Rapids. CPT 99284.
What Trinity Health Grand Rapids publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$40.48cash price (self-pay)
$253list price
$4.28–$9,539range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Mclaren Health Medicaid | Mclaren Medicaid | $233 |
| Blue Cross Complete - Mi | Blue Cross Complete Medicaid | $233 |
| Molina Medicaid | Molina Medicaid | $238 |
| Access Health | Access Health | $291 |
| Blue Cross - Mi Medicare Advantage | BCBS Medicare Advantage | $407 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $407 |
| Blue Care Network Advantage | Bcn Medicare Advantage | $407 |
| Priority Health Medicare Advantage | Priority Health Medicare Advantag | $407 |
| Hap Medicare Advantage | Hap Medicare Advantage | $407 |
| Molina Medicare Advantage | Molina Medicare Advantage | $407 |
| Align Senior Care | Align Senior Care Medicare Advantage | $416 |
| Longevity Ipa Of Michigan LLC Health Plan Isnp | Longevity Ipa Medicar | $469 |
| Wellpath | Wellpath | $644 |
| Blue Care Network | Bcn HMO | $711 |
| Wc Genex Care For Ohio | Cofinity Workers Comp | $784 |
| Wc Accident Fund | Cofinity Workers Comp | $784 |
| Wc Bunch & Associates | Cofinity Workers Comp | $784 |
| Wc Asu Risk Mgt | Cofinity Workers Comp | $784 |
| Wc Mitchell Frankenmuth | Cofinity Workers Comp | $784 |
| Wc Meijers | Cofinity Workers Comp | $784 |
| Wc Michigan | Cofinity Workers Comp | $784 |
| Wc Hartford | Cofinity Workers Comp | $784 |
| Wc Emc Insurance Company | Cofinity Workers Comp | $784 |
| Wc Guard Insurance Company | Cofinity Workers Comp | $784 |
| Wc Broadspire | Cofinity Workers Comp | $784 |
| Asr Health Benefits | Asr | $913 |
| Manhattan Life | Multiplan | $1,048 |
| Multiplan | Multiplan | $1,048 |
| Pan-American Life | Multiplan | $1,048 |
| Pai | Multiplan | $1,048 |
Inpatient
—cash price (self-pay)
$296list price
$75.40–$296range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Broward County Dept Of Health | Medicaid | $75.40 |
| Centene | Medicaid | $75.40 |
| Health New England Medicaid Advantage | Medicaid | $75.40 |
| Rx Allwin | Medicare | $116 |
| Rx Medicare | Medicare | $116 |
| Blue Cross - In (Anthem) Medicare Advantage | Medicare | $116 |
| Care Improvement Plus | Medicare | $116 |
| Um Health Advantage | Medicare | $116 |
| Wellpoint Medicare Advantage | Medicare | $116 |
| Life St Marys Pace | Medicare | $116 |
| Aurora Special Needs | Medicare | $116 |
| Optum Medicare Transplant | Medicare | $116 |
| Pace-Trinity Health | Medicare | $116 |
| Serenity Pace | Medicare | $116 |
| Central Valley Medical Services Corp Pace | Medicare | $116 |
| Huron Valley Pace | Medicare | $116 |
| Pace Cny | Medicare | $116 |
| Keystone First Chc Medicare Advantage | Medicare | $116 |
| Carefirst Medicare Advantage | Medicare | $116 |
| Welbe Health | Medicare | $116 |
| Ally Align Care Adv | Medicare | $116 |
| Solis Health Plans | Medicare | $116 |
| Siouxland Pace | Medicare | $116 |
| Longevity Ipa Of Michigan LLC Health Plan Isnp | Longevity Ipa Medicar | $133 |
| Christian Care Ministry | Multiplan | $160 |
| Molina Marketplace | Molina Marketplace | $160 |
| Asrm - Reliance Standard Life Insurance | Multiplan | $160 |
| Fallon Health | Multiplan | $160 |
| Comprehensive Benefits | Cofinity | $172 |
| The Loomis Company | Cofinity | $172 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.