Level 5 Type B Emergency Department Visit

New York 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?

$240

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $214 from a physician practice, and about $288 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 5 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	$214	$129 to $288
FacilityA hospital or hospital-owned outpatient department	A hospital or hospital-owned outpatient department	$288	$288 to $288

How much rates vary

Facilitymedian $288 · 10th to 90th $288 to $288Professionalmedian $214 · 10th to 90th $112 to $468

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 Facility Modifier Global Typical Low $288.40 Median $288.40 Typical High $288.40	Facility	Global	$288.40	$288.40	$288.40
Aetna Setting Professional Modifier Global Typical Low $194.98 Median $288.40 Typical High $630.96	Professional	Global	$194.98	$288.40	$630.96
Anthem BCBS Setting Professional Modifier Global Typical Low $104.71 Median $123.03 Typical High $165.96	Professional	Global	$104.71	$123.03	$165.96
Cigna Setting Facility Modifier Global Typical Low $64.57 Median $64.57 Typical High $64.57	Facility	Global	$64.57	$64.57	$64.57
Cigna Setting Professional Modifier Global Typical Low $190.55 Median $190.55 Typical High $190.55	Professional	Global	$190.55	$190.55	$190.55
Emblem Health Setting Facility Modifier Global Typical Low $34.67 Median $34.67 Typical High $41.69	Facility	Global	$34.67	$34.67	$41.69
United Setting Facility Modifier Global Typical Low $3,548.13 Median $3,548.13 Typical High $7,762.47	Facility	Global	$3,548.13	$3,548.13	$7,762.47
United Setting Professional Modifier Global Typical Low $281.84 Median $323.59 Typical High $323.59	Professional	Global	$281.84	$323.59	$323.59

Where New York 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.

New York· 44th of 51

$240

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.