Cost of a ER Visit (High) Visit
in Maine
Reviewed by Momentary Medical Group West PC
Maine's rural geography and limited hospital networks create unique challenges for accessing high-severity emergency care across the state's 16 counties. Patients seeking an ER Visit (High) typically pay between $170 and $337, with a median out-of-pocket cost of $246 based on negotiated insurance rates. Maine maintains 1,747 active providers handling high-severity emergency cases, allowing patients to browse all emergency providers statewide for cost comparison and availability.
Average
$251
Median
$246
Lowest
$170
Highest
$337
Providers
1,747
33% above national average
Compare Similar Procedures
How does er visit (high severity) compare to related procedures in Maine?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| ER Visit (Low Severity) Emergency department visit, low severity | 99283 | $86 | $122 | $184 | 1,743 |
| ER Visit (Moderate Severity) Emergency department visit, moderate severity | 99284 | $116 | $167 | $233 | 1,755 |
Important: These are cost estimates only — not a quote and not medical advice.
The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 99285 — Emergency department visit, high severity). They represent what a patient might pay without insurance.
Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.
This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.
Where this data comes from & what CPT 99285 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99285 (Emergency department visit, high severity), as mandated by the CMS Price Transparency Rule.
What CPT 99285 covers: the provider's professional fee for er visit (high severity). It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.
How to read this data
Negotiated Rate
The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.
P5, Median, P95
P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.
What this does not tell you
These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.
Top-Rated Hospitals in Maine
These hospitals in Maine are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
AUGUSTA, ME
HOULTON, ME
BANGOR, ME
PORTLAND, ME
BAR HARBOR, ME
Hospital ratings are based on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey data published by CMS.
Why ER Visit (High) Visit Costs Vary Across Maine
Maine's emergency care costs run approximately 12% above national averages, driven by the state's rural geography and seasonal population fluctuations that strain capacity during summer months. The concentration of advanced trauma capabilities in southern Maine creates cost disparities as patients from rural areas often require expensive transfers to higher-level facilities.
Urban vs. Rural Provider Availability
Portland and Bangor metropolitan areas contain Maine's major trauma centers and specialty emergency services, while rural counties rely on critical access hospitals with limited high-acuity capabilities. Patients in Aroostook, Washington, and Piscataquis counties frequently face ambulance transfers to distant facilities, adding transportation costs to emergency care bills. This geographic reality means rural residents often pay premium rates for high-severity emergency care due to facility limitations and transfer requirements.
Facility Type and Overhead Costs
MaineHealth and Northern Light Health systems operate most emergency departments statewide, with hospital-based facilities charging significant facility fees alongside physician services. Independent emergency physicians are rare in Maine's market, with most providers employed directly by health systems that negotiate bundled payment arrangements. Critical access hospitals receive special Medicare reimbursement rates but may lack resources for complex emergency cases requiring immediate transfer.
Insurance Market Competition in Maine
Anthem Blue Cross Blue Shield dominates Maine's individual market while Harvard Pilgrim and United Healthcare maintain smaller but significant presence in employer-sponsored plans. Limited insurer competition allows less aggressive rate negotiations compared to more competitive markets, contributing to higher emergency care costs. The state's lack of a major national insurer headquarters means less local influence over network development and rate structures.
Physician Supply and Demand in Maine
With 1,747 providers handling high-severity emergency cases, Maine maintains adequate emergency physician coverage despite ongoing recruitment challenges in rural areas. The state's aging population increases demand for high-acuity emergency services while younger physicians often prefer urban practices, creating supply-demand imbalances in remote regions. Seasonal population swings during tourist season strain emergency departments along the coast, affecting both availability and pricing during peak months.
Jayant Panwar
CEO, Momentary Labs · San Francisco, CA
Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.
The cost figures on this page reflect his ongoing work to make this data accessible to patients.
Frequently Asked Questions — ER Visit (High) Costs in Maine
What is the average cost of a ER Visit (High) visit in Maine without insurance?
Does Maine Medicaid cover ER Visit (High) visits?
How do I find an affordable ER Visit (High) near me in Maine?
What is the difference in cost between an initial consultation and a follow-up visit?
Can I use an HSA or FSA to pay for a ER Visit (High) visit in Maine?
How does telemedicine affect the cost of seeing a ER Visit (High) in Maine?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 99285)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $940 | $430 |
| 2 | New Hampshire Range: $150 – $446 | $294 |
| 3 | Illinois Range: $80 – $569 | $285 |
| 4 | Iowa Range: $85 – $538 | $275 |
| 5 | Louisiana Range: $98 – $536 | $261 |
| 6 | New York Range: $80 – $543 | $260 |
| 7 | Maine Range: $170 – $337 | $251 |
| 8 | Nebraska Range: $123 – $422 | $236 |
| 9 | Washington Range: $80 – $379 | $224 |
| 10 | Colorado Range: $80 – $390 | $219 |
| 11 | New Mexico Range: $88 – $389 | $218 |
| 12 | Wyoming Range: $88 – $385 | $217 |
| 13 | Vermont Range: $98 – $356 | $216 |
| 14 | Rhode Island Range: $80 – $429 | $202 |
| 15 | Massachusetts Range: $80 – $428 | $202 |
| 16 | Georgia Range: $85 – $333 | $198 |
| 17 | North Carolina Range: $80 – $330 | $188 |
| 18 | District of Columbia Range: $85 – $305 | $185 |
| 19 | Maryland Range: $88 – $298 | $183 |
| 20 | Michigan Range: $80 – $318 | $183 |
| 21 | Utah Range: $80 – $317 | $182 |
| 22 | New Jersey Range: $60 – $348 | $182 |
| 23 | Ohio Range: $85 – $287 | $181 |
| 24 | Mississippi Range: $126 – $250 | $181 |
| 25 | California Range: $80 – $374 | $181 |
| 26 | Hawaii Range: $80 – $313 | $179 |
| 27 | Arkansas Range: $85 – $282 | $178 |
| 28 | Virginia Range: $88 – $293 | $177 |
| 29 | Tennessee Range: $85 – $259 | $170 |
| 30 | South Carolina Range: $80 – $287 | $170 |
| 31 | Missouri Range: $88 – $239 | $168 |
| 32 | Minnesota Range: $91 – $312 | $167 |
| 33 | Oklahoma Range: $85 – $246 | $166 |
| 34 | Kansas Range: $88 – $243 | $166 |
| 35 | Alabama Range: $80 – $257 | $160 |
| 36 | Pennsylvania Range: $55 – $334 | $159 |
| 37 | Arizona Range: $80 – $250 | $157 |
| 38 | Indiana Range: $85 – $298 | $157 |
| 39 | West Virginia Range: $88 – $281 | $155 |
| 40 | Delaware Range: $85 – $203 | $155 |
| 41 | Kentucky Range: $80 – $296 | $155 |
| 42 | Nevada Range: $85 – $267 | $154 |
| 43 | Alaska Range: $80 – $292 | $151 |
| 44 | Connecticut Range: $55 – $320 | $148 |
| 45 | Idaho Range: $80 – $275 | $148 |
| 46 | Oregon Range: $80 – $250 | $142 |
| 47 | Texas Range: $80 – $257 | $142 |
| 48 | Montana Range: $80 – $213 | $124 |
| 49 | North Dakota Range: $91 – $177 | $122 |
| 50 | South Dakota Range: $98 – $161 | $119 |
| 51 | Florida Range: $35 – $246 | $114 |