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Emergency Department Visit, Level 5 (Highest)

Iowa 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?

$182

Typical physician fee. In Iowa, July 2026.

Insurers have agreed to pay about $182 for this service. Most negotiated rates run $155 to $355.

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 8 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $282 · 10th to 90th $155 to $407Professionalmedian $182 · 10th to 90th $117 to $661
$10.0$50.0$200.0$1.0Kfacility $282professional $182

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
$177.83
Typical High
$660.69
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$154.88
Median
$537.03
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$316.23
Typical High
$478.63
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$263.03
Typical High
$1,258.93
Medica
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$281.84
Typical High
$407.38
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$467.74
Median
$489.78
Typical High
$1,122.02
Medica
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$309.03
Typical High
$1,096.48
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$223.87
Median
$354.81
Typical High
$457.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$316.23
Typical High
$478.63
Midlands
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$346.74
Typical High
$912.01
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$316.23
Typical High
$407.38
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$257.04
Typical High
$549.54
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$95.50
Typical High
$245.47
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$295.12
Typical High
$295.12

Where Iowa 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.

Iowa $182 · 17th 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.