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Emergency Department Visit, Level 5 (Highest)

New Hampshire 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?

$191

Typical physician fee. In New Hampshire, July 2026.

Insurers have agreed to pay about $191 for this service. Most negotiated rates run $158 to $275.

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 $105 · 10th to 90th $102 to $1,585Professionalmedian $191 · 10th to 90th $138 to $380
$100$200$500$1Kfacility $105professional $191

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
$128.82
Median
$173.78
Typical High
$275.42
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$229.09
Median
$239.88
Typical High
$338.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$186.21
Typical High
$346.74
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$165.96
Median
$199.53
Typical High
$562.34
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$263.03
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$269.15
Typical High
$467.74
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$275.42
Typical High
$446.68
Optum
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$194.98
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$269.15
Typical High
$489.78
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$245.47
Typical High
$371.54
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$104.71
Typical High
$204.17

Where New Hampshire 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.

New Hampshire· 11th of 51

$191

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.