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Emergency Department Visit, Level 5 (Highest)

Arizona 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?

$162

Typical physician fee. In Arizona, July 2026.

Insurers have agreed to pay about $162 for this service. Most negotiated rates run $138 to $204.

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 $182 · 10th to 90th $141 to $355Professionalmedian $162 · 10th to 90th $120 to $389
$10.0$50.0$200.0$1.0Kfacility $182professional $162

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$162.18
Typical High
$363.08
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$371.54
Median
$602.56
Typical High
$1,023.29
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$173.78
Typical High
$489.78
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$162.18
Median
$234.42
Typical High
$645.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$204.17
Typical High
$436.52
Medica
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$181.97
Typical High
$354.81
Medica
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$302.00
Typical High
$1,096.48
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$501.19
Median
$851.14
Typical High
$1,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$177.83
Typical High
$389.05
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$79.43
Typical High
$89.13

Where Arizona sits

The same service costs 2.5 times more in West Virginia than in Delaware. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Arizona $162 · 45th of 51
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.