Emergency visit, high (level 4) at Southern New Hampshire Medical Center. CPT 99284.
What Southern New Hampshire Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$201cash price (self-pay)
$1,551list price
$456–$3,137range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Managed Care Plan | $456 |
| Bcbs | Anthem Pathway Individual Other Commerical | $464 |
| Wellsense | Medicare Managed Care Plan | $474 |
| Cigna | Medicare Managed Care Plan | $479 |
| Ambetter | Exchange | $593 |
| Bcbs | Anthem Pathway Small Group Exchange | $726 |
| Bcbs | Hpn Other Commercial Plan | $1,542 |
| Bcbs | Anthem Hmo/Pos | $1,695 |
| Bcbs | Anthem Ppo | $2,903 |
| Cigna | All Commercial Plans | $3,137 |
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All common services at Southern New Hampshire Medical Center