go back

Illinois 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 $355 · 10th–90th $257–$3550%50%10th$355Professionalmedian $234 · 10th–90th $105–$2340%50%10th$234$20.0$50.0$100.0$200.0$500.0

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
$354.81 / $354.81 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $234.42 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $87.10
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $61.66 / $87.10
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $14.45 / $15.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $257.04 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $275.42 / $275.42