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Emergency Department Visit, Level 5 (Highest)

Connecticut 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?

$2,740

Typical total for the visit. In Connecticut, July 2026.

Insurers have agreed to pay about $2,740 for this emergency department visit. That total is two separate charges billed under the same code: $170 to the emergency physician who treats you, and $2,570 to the hospital for the emergency department itself. Tests, imaging and treatments during the visit are billed separately.

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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe emergency physician who treats you$170$141 to $209
Facility feeThe hospital emergency department$2,570$1,862 to $3,162

How much rates vary

Facilitymedian $2,570 · 10th to 90th $1,738 to $4,169Professionalmedian $170 · 10th to 90th $123 to $537
$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $2,570professional $170

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
$123.03
Median
$165.96
Typical High
$549.54
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$97.72
Median
$575.44
Typical High
$691.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$2,187.76
Typical High
$3,715.35
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$245.47
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$223.87
Typical High
$426.58
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$309.03
Typical High
$436.52
Health New England
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$2,570.40
Typical High
$2,570.40
Health New England
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$323.59
Typical High
$537.03
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$239.88
Typical High
$363.08
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$309.03

Where Connecticut sits

The same service costs 18.8 times more in Vermont than in New Hampshire. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeConnecticut $2,740 · 2nd of 43
VT $5,557NH $295

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.