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Emergency Department Visit, Level 5 (Highest)

Colorado 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 Colorado, July 2026.

Insurers have agreed to pay about $166 for this service. Most negotiated rates run $138 to $214.

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 $158 to $372Professionalmedian $162 · 10th to 90th $117 to $407
$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0Kfacility $229professional $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
$158.49
Typical High
$407.38
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$169.82
Median
$467.74
Typical High
$575.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$234.42
Typical High
$354.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$4,897.79
Typical High
$4,897.79
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$234.42
Typical High
$389.05
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$229.09
Typical High
$371.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$269.15
Typical High
$1,548.82
Select Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$177.83
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$229.09
Typical High
$407.38
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$89.13

Where Colorado 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.

Colorado $166 · 42nd 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.