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Emergency Department Visit, Level 5 (Highest)

Montana 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 Montana, July 2026.

Insurers have agreed to pay about $174 for this service. Most negotiated rates run $138 to $282.

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

Facilitymedian $295 · 10th to 90th $186 to $355Professionalmedian $170 · 10th to 90th $112 to $427
$50.0$100.0$200.0$500.0$1.0Kfacility $295professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$426.58
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$181.97
Median
$288.40
Typical High
$660.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$275.42
Typical High
$275.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$269.15
Typical High
$371.54
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$302.00
Typical High
$331.13
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$302.00
Typical High
$331.13
Providence
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$234.42
Typical High
$416.87
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$245.47
Typical High
$436.52
United
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$281.84
Typical High
$398.11

Where Montana 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.

Montana $174 · 28th 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.