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Pennsylvania rates for HCPCS 99281

Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional

Facilitymedian $380 · 10th–90th $95$6460%10%10th90th$380Professionalmedian $28 · 10th–90th $9$660%5%10%10th90th$28$10.0$50.0$200.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $389.05 / $645.65
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$251.19 / $331.13 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $28.18 / $66.07
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$21.88 / $48.98 / $70.79
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,659.59
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $22.39 / $44.67
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $229.09 / $363.08
Highmark BCBS
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$213.80 / $229.09 / $446.68
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,659.59
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $50.12 / $371.54
Martin's Point
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $426.58 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $23.99 / $48.98
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11