Emergency visit, high (level 4) at Frisbie Memorial Hospital. CPT 99284.
What Frisbie Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 1, 2026.
Outpatient / ER
$2,819cash price (self-pay)
$2,875list price
$232–$8,445range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AmeriHealth Caritas | MCD | $237 |
| Well Sense Health Plan | MCD | $351 |
| Maine Community Health | Individual | $820 |
| Maine Community Health | SmallGroup | $820 |
| Tufts Health Plan | HMO | $986 |
| Tufts Health Plan | PPO | $986 |
| United | FreedomBenefitPlans | $986 |
| Anthem | INDEMNITY | $1,150 |
| United | AllPayerAppendix | $1,205 |
| Maine Community Health | LargeGroup | $1,390 |
| Tufts Health Plan | POS | $1,645 |
| United | OptionsPPO | $1,734 |
| EverNorth | COMM | $2,300 |
| Aetna | EPO | $3,020 |
| Aetna | HMO | $3,020 |
| Aetna | POS | $3,020 |
| Aetna | PPO | $3,020 |
| Anthem | BlueChoice | $3,240 |
| Anthem | HPN | $3,401 |
| Anthem | HMO | $3,779 |
| Anthem | IndividualOffExhange | $3,779 |
| Anthem | POS | $3,779 |
| Cigna | HMO | $5,229 |
| Cigna | PPO | $6,699 |
| Anthem | FEP | $8,445 |
| Anthem | PPO | $8,445 |
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