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 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)
Low
$44
Average
$526
Median
$437
High
$2.7k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
259 hospitals; the 90th percentile is 3.1× 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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264 hospital rates
iThe hospitals that file a Molina 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 | Wheeling Hospital, Inc. Wheeling, WV facility · other · outpatient | 2 | $395 | $260 | $156 | 60% | 37–55 | $76 – $395 |
| 2 | Wheeling Hospital, Inc. Wheeling, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $384 | $384 | — | — | 1–10 | $384 – $384 |
| 3 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 4 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $424 | $424 | — | — | — | $424 – $424 |
| 5 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $434 | $434 | — | — | — | $434 – $434 |
| 6 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $860 | $860 | — | — | — | $860 – $860 |
| 7 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $598 | $598 | $206 | 34% | — | $392 – $804 |
| 8 | Advocate Childrens Hospital Oak Lawn Oak Lawn, IL facility · case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 9 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 10 | Advocate Christ Medical Center Oak Lawn, IL facility · case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 11 | Advocate Condell Medical Center Libertyville, IL case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 12 | Advocate Good Samaritan Hospital Downers Grove, IL case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 13 | Advocate Good Shepherd Hospital Barrington, IL case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 14 | Advocate Illinois Masonic Medical Center Chicago, IL case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 15 | Advocate Lutheran General Hospital Park Ridge, IL case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 16 | Advocate Sherman Hospital Elgin, IL case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 17 | Advocate South Suburban Hospital Hazel Crest, IL case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 18 | Advocate Trinity Hospital Chicago, IL case rate · outpatient | 1 | $610 | $610 | — | — | — | $610 – $610 |
| 19 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $380 | $380 | — | — | — | $380 – $380 |
| 20 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 2 | $499 | $499 | $108 | 22% | — | $391 – $607 |
| 21 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 1 | $424 | $424 | — | — | — | $424 – $424 |
| 22 | CATHOLIC HEALTH INITIATIVES COLORADO West Valley City, UT fee schedule · outpatient | 2 | $646 | $646 | $227 | 35% | — | $420 – $873 |
| 23 | CATHOLIC HEALTH INITIATIVES COLORADO West Jordan, UT fee schedule · outpatient | 2 | $646 | $646 | $227 | 35% | — | $420 – $873 |
| 24 | CATHOLIC HEALTH INITIATIVES COLORADO Lehi, UT fee schedule · outpatient | 2 | $646 | $646 | $227 | 35% | — | $420 – $873 |
| 25 | CATHOLIC HEALTH INITIATIVES COLORADO Layton, UT fee schedule · outpatient | 1 | $873 | $873 | — | — | — | $873 – $873 |
← Payers reporting HCPCS G0384 · Snapshot 20261111T120946Z-9134e7f7