Emergency visit, high (level 4) at Southwestern Vermont Medical Center. CPT 99284.
What Southwestern Vermont Medical Center publishes for this service, straight from its standard-charges file, last updated January 1, 2025.
Outpatient / ER
$199cash price (self-pay)
$348list price
$43.76–$1,057range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CDPHP | Medicaid/CHP | $43.76 |
| UHC | Medicaid | $44.57 |
| MVP | Medicaid | $84.15 |
| MVP | Essential plan 1,2,5,6 | $84.15 |
| BMC | Healthnet Plan | $90.36 |
| HNE | Medicaid | $90.36 |
| CDPHP | Essential Plan 3 & 4 | $100 |
| CDPHP | Essential Plan 1 & 2 | $100 |
| CIGNA | Medicare Advantage | $109 |
| CDPHP | Medicare | $109 |
| Blue Cross | Medicare | $109 |
| Fidelis | Medicare | $109 |
| HNE | Medicare | $109 |
| Humana | Medicare | $109 |
| MVP | Medicare | $109 |
| UHC | Medicare | $109 |
| Wellcare | Medicare | $109 |
| Fidelis | Medicaid | $109 |
| Fidelis | CHP | $109 |
| Fidelis | Essential (Aliessa) | $109 |
| Aetna | Medicare | $109 |
| Fidelis | Exchange (QHP) | $115 |
| Fidelis | Essential | $115 |
| MVP | NY Exchange Individual Plans | $123 |
| Health New England | Commercial | $130 |
| Blue Cross | All Vermont Plans | $141 |
| Allegiance | SWVT Employee Only | $153 |
| UHC | Commercial | $153 |
| Tufts | Commercial | $156 |
| Aetna | PPO | $156 |
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