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Emergency Department Visit, Level 5 (Highest)

Arkansas rates for HCPCS 99285

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

Rates data updated July 2026.

How much does Emergency Department Visit, Level 5 (Highest) cost?

$166

Typical physician fee. In Arkansas, July 2026.

Insurers have agreed to pay about $166 for this service. Most negotiated rates run $141 to $191.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $229 · 10th to 90th $166 to $2,754Professionalmedian $166 · 10th to 90th $135 to $295
$100$200$500$1K$2Kfacility $229professional $166

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
$131.83
Median
$165.96
Typical High
$295.12
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$181.97
Median
$323.59
Typical High
$933.25
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$218.78
Typical High
$446.68
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$169.82
Median
$218.78
Typical High
$602.56
BCBS
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$2,754.23
BCBS
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$162.18
Typical High
$213.80
CareSource
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$213.80
Typical High
$229.09
CareSource
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$234.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$194.98
Typical High
$275.42
Qualchoice
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$251.19
Typical High
$707.95
Qualchoice
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$194.98
Median
$251.19
Typical High
$691.83
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$181.97
Typical High
$263.03
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$89.13

Where Arkansas sits

The same service costs 2.5 times more in West Virginia than in Delaware. 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.

Arkansas· 43rd of 51

$166

WV $372DE $148

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.