go back

Emergency Department Visit, Level 5 (Highest)

North Dakota 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 October 2026.

How much does Emergency Department Visit, Level 5 (Highest) cost?

$1,498

Typical total for the visit. In North Dakota, October 2026.

Insurers have agreed to pay about $1,498 for this emergency department visit. That total is two separate charges billed under the same code: $324 to the emergency physician who treats you, and $1,175 to the hospital for the emergency department itself. Tests, imaging and treatments during the visit are billed separately.

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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe emergency physician who treats you$324$191 to $389
Facility feeThe hospital emergency department$1,175$851 to $1,549

How much rates vary

Facilitymedian $1,175 · 10th to 90th $646 to $2,239Professionalmedian $324 · 10th to 90th $148 to $457
$200$500$1K$2K$5Kfacility $1,175professional $324

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$977.24
Typical High
$2,290.87
Aetna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$162.18
Typical High
$288.40
BCBS Minnesota
Setting
Facility
Modifier
None
Typical Low
$1,047.13
Median
$1,096.48
Typical High
$1,445.44
BCBS North Dakota
Setting
Facility
Modifier
None
Typical Low
$933.25
Median
$1,174.90
Typical High
$1,318.26
BCBS North Dakota
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$380.19
Typical High
$457.09
BCBS North Dakota
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$151.36
Median
$190.55
Typical High
$229.09
BCBS North Dakota
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$60.26
Median
$75.86
Typical High
$91.20
Cigna
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$346.74
Typical High
$467.74
Medica
Setting
Facility
Modifier
None
Typical Low
$1,000.00
Median
$1,445.44
Typical High
$2,238.72
Medica
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$338.84
Typical High
$524.81
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$295.12
Typical High
$338.84
United
Setting
Facility
Modifier
None
Typical Low
$2,818.38
Median
$2,818.38
Typical High
$2,818.38
United
Setting
Professional
Modifier
None
Typical Low
$177.83
Median
$316.23
Typical High
$426.58
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$977.24
Median
$1,318.26
Typical High
$2,187.76

Where North Dakota sits

The same service costs 9.6 times more in New Hampshire than in Idaho. 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.

Physician feeFacility fee

North Dakota· 38th of 50

$1,498

$324 physician + $1,175 facility

NH $5,599ID $582

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.