Emergency visit, high (level 4) at Franklin Memorial Hospital. CPT 99284.
What Franklin Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 9, 2025.
Outpatient / ER
$449cash price (self-pay)
$685list price
$119–$1,849range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MHACO Government | $119 |
| Aetna | Medicare Advantage | $197 |
| Anthem | Medicare Advantage | $206 |
| United Healthcare | Medicare Advantage | $206 |
| Wellcare | Medicare Advantage | $210 |
| Aetna | MHACO Commercial | $236 |
| Aetna | HMO/PPO | $423 |
| Harvard Pilgrim Healthcare | Maine's Choice | $464 |
| Cigna | Commercial | $498 |
| Harvard Pilgrim Healthcare | Commercial | $503 |
| Community Health Options | Commercial | $523 |
| United Healthcare | Commercial | $525 |
| Multiplan | Commercial | $542 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $1,027 |
Inpatient
$921cash price (self-pay)
$921list price
$698–$865range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Harvard Pilgrim Healthcare | Maine's Choice | $698 |
| Aetna | HMO/PPO | $702 |
| Cigna | Commercial | $771 |
| Harvard Pilgrim Healthcare | Commercial | $775 |
| Community Health Options | Commercial | $803 |
| United Healthcare | Commercial | $821 |
| Multiplan | Commercial | $865 |
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