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New York rates for HCPCS 99285

Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making

Facilitymedian $1,820 · 10th–90th $575$6,4570%10%10th90th$1,820Professionalmedian $191 · 10th–90th $129$6170%20%10th90th$191$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $1,445.44 / $6,456.54
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$812.83 / $2,041.74 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $177.83 / $549.54
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$162.18 / $346.74 / $724.44
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$162.18 / $169.82 / $302.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $177.83 / $407.38
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $269.15 / $645.65
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $41.69 / $416.87
Fidelis
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $208.93 / $213.80
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$190.55 / $234.42 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,801.89 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $295.12 / $575.44
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$64.57 / $89.13 / $371.54