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Emergency Department Visit, Level 5 (Highest)

Oregon 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?

$523

Typical total for the visit. In Oregon, July 2026.

Insurers have agreed to pay about $523 for this emergency department visit. That total is two separate charges billed under the same code: $214 to the emergency physician who treats you, and $309 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 9 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe emergency physician who treats you$214$158 to $380
Facility feeThe hospital emergency department$309$234 to $339

How much rates vary

Facilitymedian $309 · 10th to 90th $182 to $372Professionalmedian $214 · 10th to 90th $138 to $490
$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0Kfacility $309professional $214

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
$138.04
Median
$186.21
Typical High
$501.19
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$169.82
Median
$549.54
Typical High
$794.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$331.13
Typical High
$478.63
HealthNet
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$389.05
Typical High
$457.09
HealthNet
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$354.81
Typical High
$436.52
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$398.11
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$323.59
Typical High
$467.74
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$331.13
Typical High
$346.74
Providence
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$257.04
Typical High
$446.68
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$338.84
Typical High
$467.74
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,290.87
Typical High
$2,754.23
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$380.19
Typical High
$489.78
United
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$338.84
Typical High
$575.44
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$89.13

Where Oregon sits

The same service costs 18.8 times more in Vermont than in New Hampshire. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeOregon $523 · 14th of 43
VT $5,557NH $295

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.