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Emergency Department Visit, Level 4 (Moderate Complexity)

Vermont rates for HCPCS 99284

An emergency department visit involving a patient history and physical examination, with moderate-complexity medical decision-making. This is the fourth of the five visit levels, above the low-complexity level and one step below the highest. The extent of the history and examination is whatever is medically appropriate.

Rates data updated July 2026.

How much does Emergency Department Visit, Level 4 (Moderate Complexity) cost?

$138

Typical physician fee. In Vermont, July 2026.

Insurers have agreed to pay about $138 for this service. Most negotiated rates run $117 to $178.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $5,370 · 10th to 90th $5,370 to $5,370Professionalmedian $138 · 10th to 90th $105 to $417
$50$100$200$500$1K$2K$5Kfacility $5,370professional $138

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$134.90
Typical High
$416.87
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$144.54
Median
$234.42
Typical High
$575.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$177.83
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5,370.32
Median
$5,370.32
Typical High
$5,370.32
Cigna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$141.25
Typical High
$234.42
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$154.88
Typical High
$162.18
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$154.88
Typical High
$295.12
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$79.43
Typical High
$93.33

Where Vermont sits

The same service costs 2.1 times more in West Virginia than in Wyoming. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Vermont· 13th of 51

$138

WV $224WY $107

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.