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Nationwide rates for HCPCS G0383

Level 4 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)

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	Facility/Professional	Typical Low	Median	Typical High
Aetna Facility/Professional Facility Modifier Typical Low / Median / Typical High $234.42 / $380.19 / $2,951.21	Facility	$234.42	$380.19	$2,951.21
Aetna Facility/Professional Professional Modifier Typical Low / Median / Typical High $229.09 / $234.42 / $302.00	Professional	$229.09	$234.42	$302.00
BCBS Facility/Professional Facility Modifier Typical Low / Median / Typical High $1,348.96 / $2,818.38 / $13,182.57	Facility	$1,348.96	$2,818.38	$13,182.57
BCBS Facility/Professional Professional Modifier Typical Low / Median / Typical High $75.86 / $95.50 / $158.49	Professional	$75.86	$95.50	$158.49
Cigna Facility/Professional Facility Modifier Typical Low / Median / Typical High $64.57 / $64.57 / $64.57	Facility	$64.57	$64.57	$64.57
Cigna Facility/Professional Professional Modifier Typical Low / Median / Typical High $151.36 / $151.36 / $151.36	Professional	$151.36	$151.36	$151.36
United Facility/Professional Facility Modifier Typical Low / Median / Typical High $323.59 / $912.01 / $1,479.11	Facility	$323.59	$912.01	$1,479.11
United Facility/Professional Professional Modifier Typical Low / Median / Typical High $281.84 / $302.00 / $323.59	Professional	$281.84	$302.00	$323.59

Nationwide rates for HCPCS G0383

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