Emergency visit, high (level 4) at Baystate Franklin Medical Center. CPT 99284.
What Baystate Franklin Medical Center publishes for this service, straight from its standard-charges file, last updated June 5, 2026.
Outpatient / ER
$530cash price (self-pay)
$862list price
$87.09–$1,621range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health New England | Be Healthy MBHP ACO Masshealth | $87.09 |
| Health New England | Connector Other Commercial | $603 |
| Health New England | Fully Insured Commercial Plan | $603 |
| Health New England | ASO GIC Other Commercial | $603 |
| Health New England | Self Funded Employer Sponsored Other Commercial | $603 |
| Wellpoint | All Commercial | $733 |
| Mass General Brigham Health Plan | QHP Subsidized | $1,287 |
| Mass General Brigham Health Plan | Commercial (HMO, PPO, QHP Unsubsidi | $1,621 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.