Emergency visit, high (level 4) at Upper Valley Medical Center. CPT 99284.
What Upper Valley Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$3,716cash price (self-pay)
$3,716list price
$409–$1,263range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicare Hmo | Aetna Medicare | $409 |
| Medicare Hmo | Humana Medicare | $417 |
| Medicare Hmo | Communicare Advantage I-Snp | $421 |
| Medicare Hmo | Buckeye Medicare Advantage | $429 |
| Medicare Hmo | Devoted Health Plans | $433 |
| Anthem | Anthem Marketplace-Exchange Plans | $589 |
| Contracted Commercial | Caresource Marketplace | $613 |
| Anthem | Anthem Blue Connection High Performance Network | $947 |
| Anthem | Anthem Bcbs | $1,263 |
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