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Nationwide rates for HCPCS G0380

Level 1 hospital emergency department visit provided in a type B emergency department; (the ED must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 CFR 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)

Facilitymedian $234 · 10th–90th $112$2,0890%20%10th90th$234Professionalmedian $234 · 10th–90th $37$2340%50%10th$234$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$87.10 / $234.42 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $234.42 / $234.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,630.27 / $2,884.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $18.62 / $32.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $83.18 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $257.04 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $275.42 / $275.42