Level 5 Type B Emergency Department Visit

New Mexico 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 New Mexico, 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 $479 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	$288 to $288
FacilityA hospital or hospital-owned outpatient department	A hospital or hospital-owned outpatient department	$479	$288 to $1,288

How much rates vary

Facilitymedian $479 · 10th to 90th $288 to $1,862Professionalmedian $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. 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 $288.40 Median $288.40 Typical High $870.96	Professional	Global	$288.40	$288.40	$870.96
BCBS Setting Facility Modifier Global Typical Low $1,071.52 Median $1,288.25 Typical High $2,041.74	Facility	Global	$1,071.52	$1,288.25	$2,041.74
Cigna Setting Professional Modifier Global Typical Low $190.55 Median $190.55 Typical High $190.55	Professional	Global	$190.55	$190.55	$190.55
Molina Setting Professional Modifier Global Typical Low $33.11 Median $60.26 Typical High $70.79	Professional	Global	$33.11	$60.26	$70.79
Providence Setting Facility Modifier Global Typical Low $288.40 Median $288.40 Typical High $870.96	Facility	Global	$288.40	$288.40	$870.96
Providence Setting Professional Modifier Global Typical Low $190.55 Median $190.55 Typical High $190.55	Professional	Global	$190.55	$190.55	$190.55
United Setting Facility Modifier Global Typical Low $1,778.28 Median $1,778.28 Typical High $4,786.30	Facility	Global	$1,778.28	$1,778.28	$4,786.30

Where New Mexico sits

The same service costs 4.6 times more in North Carolina than in Rhode Island. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

New Mexico $288 · 41st of 51

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.