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California rates for HCPCS G0384

Level 5 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 $1,349 · 10th–90th $288–$16,9820%10%10th90th$1,349Professionalmedian $288 · 10th–90th $191–$4900%50%10th90th$288$100.0$500.0$2.0K$10.0K

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
$2,454.71 / $3,981.07 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $288.40 / $489.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,089.30 / $16,982.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $147.91 / $281.84
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $398.11 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $288.40 / $870.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59