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Emergency Department Visit, Level 5 (Highest)

Maryland 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?

$174

Typical physician fee. In Maryland, July 2026.

Insurers have agreed to pay about $174 for this service. Most negotiated rates run $141 to $240.

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.

How much rates vary

Professionalmedian $174 · 10th to 90th $126 to $398
$50.0$100.0$200.0$500.0$1.0Kprofessional $174

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
$123.03
Median
$165.96
Typical High
$398.11
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$169.82
Median
$380.19
Typical High
$630.96
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$181.97
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$194.98
Typical High
$346.74
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$204.17
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$190.55
Typical High
$371.54
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$89.13
Typical High
$371.54
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$204.17
Typical High
$269.15

Where Maryland 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.

Maryland $174 · 29th 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.