Emergency visit, high (level 4) at Trinity Health Livonia Hospital. CPT 99284.
What Trinity Health Livonia Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$40.48cash price (self-pay)
$3,801list price
$1.94–$19,861range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicaid | Molina Medicaid | $229 |
| Molina Medicare Advantage | Molina Medicare Advantage | $408 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $408 |
| Blue Cross - Mi Medicare Advantage | BCBS Medicare Advantage | $408 |
| Blue Care Network Advantage | Bcn Medicare Advantage | $408 |
| Priority Health Medicare Advantage | Priority Health Medicare Advantag | $408 |
| Hap Medicare Advantage | Hap Medicare Advantage | $408 |
| Php Medicare | Univ Of Michigan Health Medicare Adv | $416 |
| United Healthcare Medicare | United Healthcare Medicare Advantage | $428 |
| Total Comm Care Medicare Repl | Total Health Care Medicare Advantage | $437 |
| Longevity Ipa Of Michigan LLC Health Plan Isnp | Longevity Ipa Medicar | $469 |
| Blue Care Network | Bcn HMO | $581 |
| Kaiser Domestic | BCBS Trad / Trust | $581 |
| Blue Cross - Ar | BCBS Trad / Trust | $581 |
| Blue Cross - Ut (Regence) | BCBS Trad / Trust | $581 |
| Blue Cross - Vt | BCBS Trad / Trust | $581 |
| Blue Cross - Ri | BCBS Trad / Trust | $581 |
| Wellpath | Wellpath | $645 |
| Vitalcore | Vitalcore Physicians Group | $645 |
| Priority Health | Priority Health HMO Narrow Network | $707 |
| Priority Health | Priority Health HMO PPO | $786 |
| Health Partners | Hap Hpi | $1,201 |
| Tufts Health Plan | Hap Hpi | $1,201 |
| Hap | Hap Hpi | $1,201 |
| Family Life Insurance Company | Multiplan | $1,253 |
| Dean Health | Multiplan | $1,253 |
| Phcs | Multiplan | $1,253 |
| Manhattan Life | Multiplan | $1,253 |
| Pan-American Life | Multiplan | $1,253 |
| 1199 National Benefit Fund | Multiplan | $1,253 |
Inpatient
$40.48cash price (self-pay)
$40.48list price
$4.28–$240range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bmc Healthnet | Medicaid | $44.48 |
| Humana Medicaid | Medicaid | $44.48 |
| Care Connections Of Northern Iowa | Medicaid | $44.48 |
| Albany County Correctional Facility | Medicaid | $44.48 |
| Paramount Medicaid Advantage | Medicaid | $44.48 |
| Triwest Health Alliance | Tricare | $70.03 |
| Rx Allwin | Medicare | $71.47 |
| American Health Plan | Medicare | $71.47 |
| Iowa Health Advantage | Medicare | $71.47 |
| Central Health Medicare Advantage | Medicare | $71.47 |
| Mass General Brigham Mcr Adv | Medicare | $71.47 |
| Scan Health Plan Mcr Ipa Meritage Oon | Medicare | $71.47 |
| Carepartners Of Connecticut Medicare Advantage | Medicare | $71.47 |
| Medicare Medical Associates Health Plans | Medicare | $71.47 |
| Blue Cross - Ky (Anthem) Medicare Advantage | Medicare | $71.47 |
| Longevity Health Plan | Medicare | $71.47 |
| Commonwealth Care Alliance Medicare | Medicare | $71.47 |
| Dean Health Medicare Select | Medicare | $71.47 |
| Ally Align Care Adv | Medicare | $71.47 |
| Keystone First Chc Medicare Advantage | Medicare | $71.47 |
| Employee Benefit Concepts | Cofinity | $81.34 |
| Jfp Benefit Management | Cofinity | $81.34 |
| Healthgram | Cofinity | $81.34 |
| Wc Accident Fund | Cofinity Workers Comp | $101 |
| Wc Walmart | Cofinity Workers Comp | $101 |
| Blue Shield - CA | BCBS Trust Trad | $111 |
| Blue Cross - Ms | BCBS Trust Trad | $111 |
| Blue Cross - La | BCBS Trust Trad | $111 |
| Blue Cross - Sd (Wellmark) | BCBS Trust Trad | $111 |
| Blue Cross - Al | BCBS Trust Trad | $111 |
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