go back

Level 1 Type B Emergency Department Visit

Pennsylvania 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)

Rates data updated July 2026.

Facilitymedian $91 · 10th–90th $55$2340%20%40%10th90th$91Professionalmedian $234 · 10th–90th $110$2340%50%10th$234$50.0$100.0$200.0

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
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$234.42
Typical High
$234.42
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$234.42
Typical High
$234.42
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$67.61
Typical High
$91.20
United
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42