Emergency visit, high (level 4) at Plaistow Emergency Room. CPT 99284.
What Plaistow Emergency Room publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$7,540cash price (self-pay)
$7,540list price
$233–$9,805range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AmeriHealth Caritas | MCD | $233 |
| Well Sense Health Plan | MCD | $565 |
| United | FreedomBenefitPlans | $1,583 |
| Maine Community Health | Individual | $2,358 |
| Maine Community Health | SmallGroup | $2,358 |
| Anthem | BlueChoice | $3,150 |
| United | AllPayerAppendix | $3,167 |
| Aetna | EPO | $3,267 |
| Aetna | HMO | $3,267 |
| Aetna | POS | $3,267 |
| Aetna | PPO | $3,267 |
| Anthem | INDEMNITY | $3,295 |
| Anthem | HMO | $3,649 |
| Anthem | POS | $3,649 |
| Maine Community Health | LargeGroup | $3,996 |
| Tufts Health Plan | POS | $4,313 |
| Tufts Health Plan | HMO | $4,443 |
| Tufts Health Plan | PPO | $4,443 |
| United | OptionsPPO | $4,577 |
| MVP Health Plan | COMM | $5,278 |
| CorVel | WorkersComp | $5,429 |
| EverNorth | COMM | $6,032 |
| Healthcare Value Mgmt | COMM | $6,334 |
| First Health | PPO | $6,409 |
| Oxford Health Plans | COMM | $7,163 |
| Cigna | HMO | $7,699 |
| Anthem | FEP | $8,388 |
| Anthem | PPO | $8,388 |
| Cigna | PPO | $9,805 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.