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
$380
Average
$391
Median
$385
High
$429
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
14 hospitals; the 90th percentile is 1.1× 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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14 hospital rates
iThe hospitals that file a Wellmark 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 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $380 | $380 | — | — | — | $380 – $380 |
| 2 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $385 | $385 | — | — | — | $385 – $385 |
| 3 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $385 | $385 | — | — | — | $385 – $385 |
| 4 | MercyOne Genesis Davenport Medical Center IA 52803; 2140 53rd Avenue Bettendorf, IA facility · fee schedule · outpatient | 1 | $387 | $387 | — | — | — | $387 – $387 |
| 5 | MercyOne Genesis Davenport West Medical Center Davenport, IA facility · fee schedule · outpatient | 1 | $387 | $387 | — | — | — | $387 – $387 |
| 6 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 7 | Northwest Iowa Hospital Corporation Sioux City, IA case rate · outpatient | 1 | $401 | $401 | — | — | — | $401 – $401 |
| 8 | St Luke's Methodist Hospital Marion, IA case rate · outpatient | 1 | $382 | $382 | — | — | — | $382 – $382 |
| 9 | The Finley Hospital Dubuque, IA case rate · outpatient | 1 | $394 | $394 | — | — | — | $394 – $394 |
| 10 | Trinity Medical Center Rock Island, IL case rate · outpatient | 1 | $429 | $429 | — | — | — | $429 – $429 |
| 11 | Trinity Medical Center Bettendorf, IA case rate · outpatient | 1 | $380 | $380 | — | — | — | $380 – $380 |
| 12 | Trinity Regional Medical Center Fort Dodge, IA case rate · outpatient | 1 | $380 | $380 | — | — | — | $380 – $380 |
| 13 | Unity Healthcare Muscatine, IA case rate · outpatient | 1 | $380 | $380 | — | — | — | $380 – $380 |
| 14 | UnityPoint Health Marshalltown Marshalltown, IA case rate · outpatient | 1 | $380 | $380 | — | — | — | $380 – $380 |
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