Emergency visit, high (level 4) at Mount Carmel Grove City. CPT 99284.
What Mount Carmel Grove City publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$268cash price (self-pay)
$3,026list price
$83.69–$4,096range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Medicare Advantage | Aetna Medicare Advantage | $387 |
| Hospice Mount Carmel | Mount Carmel Hospice | $395 |
| Molina Medicare Advantage | Molina Medicare Advantage | $406 |
| Aetna Medicare Advantage | Aetna Better Health Medicare Advantage | $406 |
| Oscar | Oscar | $651 |
| Enterprise Group Planning | Enterprise Group Planning Medicare Adv | $762 |
| Custom Design Benefits | Custom Design Benefit | $825 |
| Quality Care Partners | Quality Care Partners | $892 |
| Blue Cross - IL Alternate | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Wi (Anthem) | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Mn | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - IL | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Ia (Wellmark) | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - NY (Anthem) | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Nm | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Nj (Horizon) | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Sc | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Ak (Premera) | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Az | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Al | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Sd (Wellmark) | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Ms | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - MA | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Md (Carefirst) | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Me (Anthem) | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - La | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Care Network | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Ks | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - In (Anthem) | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
| Blue Cross - Mi | Anthem Blue Access PPO Blue Pref HMO | $1,501 |
Inpatient
$276cash price (self-pay)
$276list price
$75.40–$276range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Commonwealth Care Alliance | Pb Xr 100% Default | $276 |
| Molina Medicare Advantage | Pb Xr 100% Default | $276 |
| Union Health Service | Pb Xr 100% Default | $276 |
| Harvard Pilgrim Healthcare | Pb Xr 100% Default | $276 |
| Rx Allwin | Pb Xr 100% Default | $276 |
| Pace Of Southwest Michigan | Pb Xr 100% Default | $276 |
| Dentaquest | Pb Xr 100% Default | $276 |
| Everence | Pb Xr 100% Default | $276 |
| The Health Plan | Pb Xr 100% Default | $276 |
| Health Choices | Pb Xr 100% Default | $276 |
| Rensselaer County Jail | Pb Xr 100% Default | $276 |
| Jvhl Humana Gld Ch Ptb | Pb Xr 100% Default | $276 |
| Jvhl Dmc Care Par | Pb Xr 100% Default | $276 |
| Jvhl Mclaren HMO Hx | Pb Xr 100% Default | $276 |
| Cmh Montcalm County | Pb Xr 100% Default | $276 |
| Cmh Newaygo County | Pb Xr 100% Default | $276 |
| Cmh Oakland County | Pb Xr 100% Default | $276 |
| Cmh Lenawee County | Pb Xr 100% Default | $276 |
| Cmh Monroe County | Pb Xr 100% Default | $276 |
| Cmh Misc | Pb Xr 100% Default | $276 |
| Cmh Muskegon County | Pb Xr 100% Default | $276 |
| Cmh Kent County | Pb Xr 100% Default | $276 |
| Cmh Livingston County | Pb Xr 100% Default | $276 |
| Tenncare | Pb Xr 100% Default | $276 |
| Delta Dental Nj | Pb Xr 100% Default | $276 |
| Parkland Community Health Plan | Pb Xr 100% Default | $276 |
| Freedom First Healthcare | Pb Xr 100% Default | $276 |
| Childrens Medical Services Title 19 | Pb Xr 100% Default | $276 |
| Childrens Medical Center Health Plan Managed Medicaid | Pb Xr 100% Def | $276 |
| Independent Care Medicaid | Pb Xr 100% Default | $276 |
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