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Level 5 Type B Emergency Department Visit

Wisconsin 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 October 2026.

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

$437

Typical negotiated rate. In Wisconsin, October 2026.

Insurers have agreed to pay about $437 for this service. The price depends on where it is billed: about $219 from a physician practice, and about $3,467 from a hospital or other facility.

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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$219$191 to $871
FacilityA hospital or hospital-owned outpatient department$3,467$1,023 to $5,129

How much rates vary

Facilitymedian $3,467 · 10th to 90th $871 to $6,026Professionalmedian $219 · 10th to 90th $191 to $1,175
$200$500$1K$2K$5Kfacility $3,467professional $219

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$870.96
Median
$870.96
Typical High
$870.96
Aetna
Setting
Professional
Modifier
None
Typical Low
$870.96
Median
$870.96
Typical High
$1,258.93
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$3,090.30
Median
$4,265.80
Typical High
$6,760.83
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$218.78
Typical High
$218.78
Cigna
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
DeanCare
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Medica
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$1,023.29
Typical High
$1,023.29
Prevea360
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Quartz
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
United
Setting
Facility
Modifier
None
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,096.48

Where Wisconsin sits

The same service costs 12.3 times more in North Carolina than in Montana. 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.

Wisconsin· 5th of 51

$437

NC $977MT $79.43

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.