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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 July 2026.

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

$178

Typical physician fee. In North Dakota, July 2026.

Insurers have agreed to pay about $178 for this service. Most negotiated rates run $148 to $407.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $209 · 10th to 90th $145 to $372Professionalmedian $178 · 10th to 90th $135 to $525
$200$500$1Kfacility $209professional $178

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$165.96
Typical High
$524.81
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$144.54
Median
$416.87
Typical High
$602.56
BCBS
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$380.19
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$371.54
Typical High
$524.81
Medica
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$208.93
Typical High
$371.54
Medica
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$354.81
Typical High
$524.81
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$269.15
Median
$331.13
Typical High
$524.81
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$295.12
Typical High
$457.09

Where North Dakota sits

The same service costs 2.5 times more in West Virginia than in Delaware. 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.

North Dakota· 26th of 51

$178

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.