go back

Emergency Department Visit, Level 5 (Highest)

Delaware 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?

$148

Typical physician fee. In Delaware, July 2026.

Insurers have agreed to pay about $148 for this service. Most negotiated rates run $132 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 4 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $148 · 10th to 90th $120 to $209
$100$200$500professional $148

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
$120.23
Median
$144.54
Typical High
$208.93
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$562.34
Median
$2,951.21
Typical High
$6,760.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$199.53
Typical High
$371.54
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$323.59
Highmark BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$245.47
Median
$316.23
Typical High
$870.96
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$177.83
Typical High
$478.63

Where Delaware 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.

Delaware· 51st of 51

$148

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.