Emergency visit, high (level 4) at HealthAlliance-Clinton, Leominster Campus. CPT 99284.
What HealthAlliance-Clinton, Leominster Campus publishes for this service, straight from its standard-charges file, last updated March 26, 2026.
Outpatient / ER
$1,828cash price (self-pay)
$1,828list price
$294–$1,828range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHAMPVA [11001] | All TRICARE / CHAMPVA HA [167] Plans | $455 |
| WELLPOINT [11112] | All WELLPOINT (UNICARE) HA [57] Plans | $458 |
| INSTITUTION [10406] | All HOSPICE GENERIC [237] Plans | $500 |
| TUFTS DUAL [10111] | All TUFTS UNIFY HA [231] Plans | $500 |
| CORRECTIONAL CARE [11003] | All CORRECTIONAL CARE STATE HA [95] Plans | $506 |
| CORRECTIONAL CARE [11003] | All CORRECTIONAL CARE FORT DEVENS HA [162] | $506 |
| TUFTS US FAMILY [11203] | All TUFTS US FAMILY HA [291] Plans | $506 |
| CIGNA MCR [10121] | All MEDICARE ADVANTAGE (MINUS IME) HA [134] Plans | $506 |
| MEDICAID [20301] | All MEDICAID OF CT [28] Plans | $506 |
| INSTITUTION [10406] | All HOSPICE HA [157] Plans | $506 |
| MEDICARE [20206] | All MEDICARE/ MEDICARE ADV PLANS/ INST HA [98] Plan | $506 |
| BCBS MCR [10102] | All BC MCR HA [66] Plans | $517 |
| COMMONWEALTH CARE MCR [10115] | All ONE CARE HA [224] Plans | $525 |
| AETNA MCR [10101] | All MEDICARE ADV AT 105% HA [244] Plans | $525 |
| TUFTS MCR [10112] | All TUFTS MCR HA [249] Plans | $525 |
| FALLON MCR SUPP [20202] | All FALLON SENIOR HA [112] Plans | $525 |
| UHC DUAL [10118] | All UHC COMMUNITY CARE SCO (EVERCARE) HA [229] Plan | $532 |
| HARVARD PILGRIM MCR [10106] | All HARVARD PILGRIM MCR HA [143] Plans | $532 |
| HARVARD PILGRIM [10701] | All HARVARD PILGRIM HMO HA [119] Plans | $536 |
| SENIOR WHOLE HEALTH [10110] | All SENIOR WHOLE HEALTH HA [131] Plans | $542 |
| UHC MCR REPLACE AARP [10114] | All UHC MCR HA [318] Plans | $542 |
| HARVARD PILGRIM [10701] | All HARVARD PILGRIM PPO HA [120] Plans | $616 |
| UHC MEDICAID [11130] | All UHC RHODY PARTNERS [271] Plans | $620 |
| HARVARD PILGRIM [10701] | All HARVARD PILGRIM BETH ISRAEL LAHEY HA [26 | $643 |
| BCBS [10301] | All BC PPO HA [58] Plans | $654 |
| BCBS [10301] | All BC HMO HA [61] Plans | $666 |
| CIGNA HEALTH PLAN [11104] | All CIGNA HA [46] Plans | $927 |
| FALLON CONNECTORCARE [10503] | All FALLON HMO HA [111] Plans | $930 |
| MEDICAID [20301] | All MEDICAID OF MAINE [283] Plans | $951 |
| UHC [11111] | All UHC HA [125] Plans | $982 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at HealthAlliance-Clinton, Leominster Campus