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Emergency Department Visit, Level 5 (Highest)

Missouri 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 Missouri, July 2026.

Insurers have agreed to pay about $182 for this service. Most negotiated rates run $145 to $269.

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 $219 · 10th to 90th $138 to $389Professionalmedian $182 · 10th to 90th $117 to $417
$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $219professional $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
$169.82
Typical High
$426.58
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$208.93
Median
$380.19
Typical High
$870.96
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$218.78
Typical High
$524.81
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$158.49
Median
$213.80
Typical High
$524.81
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$199.53
Typical High
$295.12
BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$194.98
Typical High
$257.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$218.78
Typical High
$371.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$218.78
Typical High
$389.05
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$199.53
Median
$524.81
Typical High
$1,698.24
Medica
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$234.42
Typical High
$1,096.48
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$199.53
Median
$251.19
Typical High
$323.59
Qualchoice
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,801.89
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$190.55
Typical High
$354.81
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$89.13
Typical High
$245.47

Where Missouri 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.

Missouri $182 · 21st 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.