Emergency visit, high (level 4) at Stephens Memorial Hospital. CPT 99284.
What Stephens Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 9, 2025.
Outpatient / ER
$757cash price (self-pay)
$764list price
$119–$1,959range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MHACO Government | $119 |
| Anthem | Medicare Advantage | $211 |
| Aetna | Medicare Advantage | $216 |
| United Healthcare | Medicare Advantage | $216 |
| Humana | Medicare Advantage | $216 |
| Wellcare | Medicare Advantage | $224 |
| Aetna | MHACO Commercial | $236 |
| Aetna | HMO/PPO | $426 |
| Harvard Pilgrim Healthcare | Maine's Choice | $446 |
| Multiplan | Commercial | $464 |
| United Healthcare | Commercial | $478 |
| Community Health Options | Commercial | $481 |
| Harvard Pilgrim Healthcare | Commercial | $482 |
| Cigna | Commercial | $545 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $1,098 |
Inpatient
$757cash price (self-pay)
$757list price
$661–$734range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Harvard Pilgrim Healthcare | Maine's Choice | $661 |
| Aetna | HMO/PPO | $692 |
| Cigna | Commercial | $705 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $707 |
| Multiplan | Commercial | $711 |
| Community Health Options | Commercial | $719 |
| United Healthcare | Commercial | $727 |
| Harvard Pilgrim Healthcare | Commercial | $734 |
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