Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
LEVEL 4 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)
Low
$250
Average
$484
Median
$269
High
$911
Each hospital's average Medical Mutual rate, under the methodology and billing class chosen below.
24 hospitals; the 90th percentile is 3.5× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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26 hospital rates
iThe hospitals that file a Medical Mutual rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $782 | $782 | — | — | — | $782 – $782 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 3 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $263 | $263 | — | — | — | $263 – $263 |
| 4 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 1 | $782 | $782 | — | — | — | $782 – $782 |
| 5 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $268 | $268 | — | — | — | $268 – $268 |
| 6 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · outpatient | 1 | $782 | $782 | — | — | — | $782 – $782 |
| 7 | JEFFERSON REGIONAL MEDICAL CENTER JEFFERSON HILLS, PA fee schedule · outpatient | 1 | $676 | $676 | — | — | — | $676 – $676 |
| 8 | McCullough-Hyde Memorial Hospital, Inc. Oxford, OH facility · fee schedule · outpatient | 1 | $263 | $263 | — | — | — | $263 – $263 |
| 9 | SAINT VINCENT HEALTH CENTER ERIE, PA fee schedule · outpatient | 1 | $663 | $663 | — | — | — | $663 – $663 |
| 10 | TRINITY HOSPITAL HOLDING COMPANY St.Clairsville, OH case rate · outpatient | 1 | $264 | $264 | — | — | — | $264 – $264 |
| 11 | The Good Samaritan Hospital of Cincinnati, OH Cincinnati, OH facility · fee schedule · outpatient | 1 | $263 | $263 | — | — | — | $263 – $263 |
| 12 | University Hospitals Health System Chardon, OH facility · fee schedule · outpatient | 1 | $250 | $250 | — | — | — | $250 – $250 |
| 13 | University Hospitals Health System Ravenna, OH facility · fee schedule · outpatient | 1 | $270 | $270 | — | — | — | $270 – $270 |
| 14 | University Hospitals Health System Chardon, OH facility · fee schedule · outpatient | 1 | $250 | $250 | — | — | — | $250 – $250 |
| 15 | University Hospitals Health System Beachwood, OH facility · case rate · outpatient | 3 | $633 | $633 | — | — | — | $633 – $633 |
| 16 | University Hospitals Health System Beachwood, OH facility · fee schedule · outpatient | 2 | $303 | $303 | $53 | 17% | — | $250 – $355 |
| 17 | University Hospitals Health System Concord Township, OH facility · case rate · outpatient | 4 | $643 | $630 | $28 | 4% | — | $581 – $652 |
| 18 | University Hospitals Health System Concord Township, OH facility · fee schedule · outpatient | 1 | $250 | $250 | — | — | — | $250 – $250 |
| 19 | University Hospitals Health System Cleveland, OH facility · fee schedule · outpatient | 1 | $250 | $250 | — | — | — | $250 – $250 |
| 20 | University Hospitals Health System Parma, OH facility · fee schedule · outpatient | 1 | $250 | $250 | — | — | — | $250 – $250 |
| 21 | University Hospitals Health System Beachwood, OH facility · fee schedule · outpatient | 1 | $250 | $250 | — | — | — | $250 – $250 |
| 22 | University Hospitals Health System Elyria, OH facility · fee schedule · outpatient | 1 | $250 | $250 | — | — | — | $250 – $250 |
| 23 | WEST PENN ALLEGHENY HEALTH SYSTEM INC WEXFORD, PA fee schedule · outpatient | 1 | $911 | $911 | — | — | — | $911 – $911 |
| 24 | WEST PENN ALLEGHENY HEALTH SYSTEM INC PITTSBURGH, PA fee schedule · outpatient | 1 | $911 | $911 | — | — | — | $911 – $911 |
| 25 | WEST PENN ALLEGHENY HEALTH SYSTEM INC MONROEVILLE, PA fee schedule · outpatient | 1 | $802 | $802 | — | — | — | $802 – $802 |
← Payers reporting HCPCS G0383 · Snapshot 20261111T120946Z-9134e7f7