Level 5 Type B Emergency Department Visit

Massachusetts 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)

Rates data updated July 2026.

How much does Level 5 Type B Emergency Department Visit cost?

$288

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $288 for this service. The price depends on where it is billed: about $288 from a physician practice, and about $100 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed by	Who charges it	Typical	Range
Physician practiceA doctor's office, clinic or independent provider	A doctor's office, clinic or independent provider	$288	$195 to $468
FacilityA hospital or hospital-owned outpatient department	A hospital or hospital-owned outpatient department	$100	$100 to $603

How much rates vary

Facilitymedian $100 · 10th to 90th $79 to $2,818Professionalmedian $288 · 10th to 90th $191 to $871

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Professional Modifier Global Typical Low $190.55 Median $288.40 Typical High $870.96	Professional	Global	$190.55	$288.40	$870.96
AllWays Health Partners Setting Facility Modifier Global Typical Low $100.00 Median $100.00 Typical High $100.00	Facility	Global	$100.00	$100.00	$100.00
Cigna Setting Professional Modifier Global Typical Low $190.55 Median $190.55 Typical High $190.55	Professional	Global	$190.55	$190.55	$190.55
Fallon Health Setting Facility Modifier Global Typical Low $79.43 Median $79.43 Typical High $79.43	Facility	Global	$79.43	$79.43	$79.43
Mass General Brigham Setting Facility Modifier Global Typical Low $100.00 Median $100.00 Typical High $100.00	Facility	Global	$100.00	$100.00	$100.00
United Setting Facility Modifier Global Typical Low $602.56 Median $602.56 Typical High $2,818.38	Facility	Global	$602.56	$602.56	$2,818.38
United Setting Professional Modifier Global Typical Low $323.59 Median $323.59 Typical High $323.59	Professional	Global	$323.59	$323.59	$323.59

Where Massachusetts sits

The same service costs 4.6 times more in North Carolina than in Rhode Island. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Massachusetts· 4th of 51

$288

NC $871RI $191

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.