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Emergency Department Visit, Level 5 (Highest)

Oklahoma 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 Oklahoma, July 2026.

Insurers have agreed to pay about $178 for this service. Most negotiated rates run $148 to $209.

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 $251 · 10th to 90th $186 to $661Professionalmedian $178 · 10th to 90th $138 to $251
$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $251professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$162.18
Typical High
$245.47
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$162.18
Median
$549.54
Typical High
$977.24
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$165.96
Typical High
$302.00
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$141.25
Median
$169.82
Typical High
$257.04
BCBS
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$588.84
Typical High
$851.14
BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$177.83
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$204.17
Typical High
$302.00
Medica
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$223.87
Typical High
$457.09
Medica
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$645.65
Median
$645.65
Typical High
$1,023.29
Medica
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$213.80
Typical High
$1,096.48
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$208.93
Median
$275.42
Typical High
$776.25
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$177.83
Typical High
$257.04
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$75.86
Median
$89.13
Typical High
$416.87

Where Oklahoma 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.

Oklahoma $178 · 24th 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.