Emergency visit, high (level 4) at Brattleboro Memorial Hospital. CPT 99284.
What Brattleboro Memorial Hospital publishes for this service, straight from its standard-charges file, last updated December 29, 2025.
Outpatient / ER
$240cash price (self-pay)
$433list price
$97.95–$1,750range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerihealth-Caritas | Managed Medicaid | $97.95 |
| New Hampshire Healthy Families | Managed Medicaid | $97.95 |
| Wellsense | Managed Medicaid | $97.95 |
| Anthem | Individual Pathway Exchange | $112 |
| Anthem | Medicare Advantage | $112 |
| Cigna | Medicare Advantage | $112 |
| Harvard Pilgrim Health Care | Medicare Advantage | $112 |
| Martin's Point | Medicare Advantage | $112 |
| MVP Healthcare | Medicare Advantage | $112 |
| New Hampshire Healthy Families (WellCare) | Medicare Advantage | $117 |
| Wellsense | Medicare Advantage | $120 |
| Harvard Pilgrim Health Care | Commercial | $134 |
| Harvard Pilgrim Health Care | Elevate Health | $134 |
| Harvard Pilgrim Health Care | Exchange | $134 |
| Blue Cross Blue Shield of Vermont | Commercial | $141 |
| Vermont Health Plan | All Plans | $141 |
| Blue Cross Blue Shield of Vermont | Medicare Advantage | $144 |
| Tufts Health Plan | All Commercial Plans | $151 |
| Tufts Health Plan | Managed Medicaid | $151 |
| Tufts Health Plan | Medicare Advantage | $151 |
| Anthem | Group Pathway Exchange | $157 |
| Anthem | Commercial | $163 |
| United Healthcare | Medicare Advantage | $408 |
| Humana | Medicare Advantage | $408 |
| Aetna | All Plans | $420 |
| Coventry | All Plans | $420 |
| MultiPlan | All Plans | $490 |
| MVP Healthcare | Commercial | $490 |
| Cigna | Commercial | $1,714 |
| United Healthcare | Commercial | $1,714 |
Inpatient
$1,263cash price (self-pay)
$1,805list price
$1,050–$1,750range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Harvard Pilgrim Health Care | Exchange | $1,050 |
| Harvard Pilgrim Health Care | Elevate Health | $1,371 |
| Tufts Health Plan | Managed Medicaid | $1,387 |
| Harvard Pilgrim Health Care | Commercial | $1,570 |
| Tufts Health Plan | Medicare Advantage | $1,572 |
| Vermont Health Plan | All Plans | $1,615 |
| Blue Cross Blue Shield of Vermont | Commercial | $1,624 |
| MVP Healthcare | Commercial | $1,624 |
| Tufts Health Plan | All Commercial Plans | $1,640 |
| Cigna | Commercial | $1,714 |
| United Healthcare | Commercial | $1,714 |
| Aetna | All Plans | $1,750 |
| Coventry | All Plans | $1,750 |
| Health New England | All Plans | $1,750 |
| MultiPlan | All Plans | $1,750 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.