Emergency visit, high (level 4) at Penobscot Valley Hospital. CPT 99284.
What Penobscot Valley Hospital publishes for this service, straight from its standard-charges file, last updated April 24, 2026.
Outpatient / ER
$429cash price (self-pay)
$632list price
$110–$677range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare B ME JK | Default | $110 |
| Wellcare Health Plan Inc MCR Adv | Default | $111 |
| Humana | Medicare Advantage | $128 |
| Blue Cross Blue Shield of ME Anthem | Medicare Advantage | $131 |
| United Healthcare | Default | $172 |
| Medicare A ME JK | Default | $187 |
| United Healthcare | Medicare Advantage | $187 |
| VA Community Care Network VACCN Region 1-3 Optum | Default | $191 |
| Aetna Medicare Advantage | Medicare Advantage | $269 |
| Harvard Pilgrim HealthCare | Default | $546 |
| Blue Cross Blue Shield of ME Anthem | Default | $572 |
| Cigna | Default | $594 |
| Aetna | Default | $607 |
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