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Virginia rates for HCPCS G0382

Level 3 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 $257 · 10th–90th $229–$4470%20%10th90th$257Professionalmedian $240 · 10th–90th $62–$2950%20%40%10th90th$240$50.0$100.0$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $239.88 / $295.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $72.44 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $251.19 / $251.19
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $257.04 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00