Emergency visit, high (level 4) at Trinity Health Shelby Hospital. CPT 99284.
What Trinity Health Shelby Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$933cash price (self-pay)
$2,391list price
$251–$3,678range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| U Of M Health Plan | Univ Of Mi Hlth Plan Mi Care Network PPO | $272 |
| Blue Cross Complete - Mi | Blue Cross Complete Medicaid | $314 |
| Mclaren Health Medicaid | Mclaren Medicaid | $314 |
| Hap Medicaid | Hap Caresource Medicaid | $314 |
| Molina Medicaid | Molina Medicaid | $321 |
| Wellpath | Wellpath | $625 |
| Longevity Ipa Of Michigan LLC Health Plan Isnp | Longevity Ipa Medicar | $674 |
| Wc Amtrust | Cofinity Workers Comp | $1,886 |
| Wc Broadspire | Cofinity Workers Comp | $1,886 |
| Wc Liberty Mutual | Cofinity Workers Comp | $1,886 |
| Wc Esis | Cofinity Workers Comp | $1,886 |
| Wc Federated | Cofinity Workers Comp | $1,886 |
| Wc Gallagher Bassett | Cofinity Workers Comp | $1,886 |
| Wc Allied | Cofinity Workers Comp | $1,886 |
| Wc Bunch & Associates | Cofinity Workers Comp | $1,886 |
| Geha | Aetna PPO And Preferred | $1,903 |
| Asr Health Benefits | Asr | $1,991 |
| Health Choices | BCBS Trad / Trust | $2,044 |
| Blue Cross - Sc | BCBS Trad / Trust | $2,044 |
| Blue Cross - Pa (Capital) | BCBS Trad / Trust | $2,044 |
| Blue Cross - Ri | BCBS Trad / Trust | $2,044 |
| Blue Cross - Vt | BCBS Trad / Trust | $2,044 |
| Blue Cross - Va (Anthem) | BCBS Trad / Trust | $2,044 |
| Blue Cross - Tn | BCBS Trad / Trust | $2,044 |
| Blue Cross - Ok | BCBS Trad / Trust | $2,044 |
| Blue Cross - Or (Regence) | BCBS Trad / Trust | $2,044 |
| Blue Cross - Pa (Independence) | BCBS Trad / Trust | $2,044 |
| Blue Shield - Pa (Highmark) | BCBS Trad / Trust | $2,044 |
| Phcs | Multiplan | $2,056 |
| Dean Health | Multiplan | $2,056 |
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