Emergency visit, high (level 4) at Bellville Medical Center. CPT 99284.
What Bellville Medical Center publishes for this service, straight from its standard-charges file, last updated June 1, 2026.
Outpatient / ER
$377cash price (self-pay)
$1,560list price
$90.48–$1,560range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Health Inc. | Medicare Advantage | $426 |
| Blue Cross Blue Sheild | Medicare Advantage PPO | $426 |
| Blue Cross Blue Sheild | Medicare Advantage HMO | $426 |
| Community Health | Medicare Advantage | $426 |
| Molina | Medicare Advantage | $426 |
| Scott & White | Medicare Advantage | $426 |
| Superior | Commericial | $426 |
| Superior | Medicare Advantage | $426 |
| TriWest | Medicare Advantage | $426 |
| United | Medicare Advantage | $426 |
| Amerigroup | Managed Medicaid | $555 |
| Community Health | Managed Medicaid | $555 |
| Molina | Managed Medicaid | $555 |
| Multiplan | Managed Medicaid | $555 |
| Scott & White | Managed Medicaid | $555 |
| Tesas Children's Health Plan | Managed Medicaid | $555 |
| United | Managed Medicaid | $555 |
| United | Commericial | $855 |
| Cigna | Commericial | $950 |
| HealthSmart | Commericial | $1,248 |
| Blue Cross Blue Sheild | Traditional | $1,560 |
| Blue Cross Blue Sheild | Essentials | $1,560 |
| Blue Cross Blue Sheild | Medicare Advantage | $1,560 |
| Scott & White | Commericial | $1,560 |
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