Emergency visit, high (level 4) at Northern Light Sebasticook Valley Hospital. CPT 99284.
What Northern Light Sebasticook Valley Hospital publishes for this service, straight from its standard-charges file, last updated March 30, 2026.
Outpatient / ER
$415cash price (self-pay)
$1,222list price
$112–$3,000range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MCR Advantage | $131 |
| Martin's Point | MCR Advantage | $131 |
| UHC | MCR Advantage | $131 |
| Wellcare | MCR Advantage | $131 |
| Anthem | MCR Advantage | $132 |
| Harvard | Commercial | $527 |
| UHC | Commercial | $561 |
| CHO | Commercial | $713 |
| Anthem | Commercial | $794 |
| Anthem | Enhanced Pathways | $794 |
| Aetna | Commercial | $825 |
| Cigna | Commercial | $912 |
Inpatient
$415cash price (self-pay)
$1,222list price
$794–$1,222range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Commercial | $794 |
| Anthem | Enhanced Pathways | $794 |
| UHC | Commercial | $886 |
| Cigna | Commercial | $912 |
| Aetna | Commercial | $917 |
| CHO | Commercial | $1,222 |
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All common services at Northern Light Sebasticook Valley Hospital