Emergency room visit (high complexity)

An ER visit for a serious problem needing extensive evaluation.
Code 99284 · Emergency & hospital · statewide summary · negotiated in-network prices
Payers shown: SummaCare
Prices shown: emergency department visits
Doctor’s fee or facility fee? These are the emergency doctor's fees only. The hospital bills its own emergency-room facility fee on top, usually several times larger, and it is not included here.
Who is counted: SummaCare lists clinicians individually: 98% of the 40,581 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs. SummaCare’s files name 11,907 providers for this procedure; 3,915 are counted here: the clinicians whose specialty performs it — mostly Nurse Practitioner, Physician Assistant and Family Medicine — and the practices, clinics and hospitals. Insurers attach their whole fee schedule to every contracted provider, so the rest are clinicians listed at a price for something they never do; counting them would inflate the provider count and pull the typical price towards the fee schedule’s floor.
Not on this map: Files SummaCare lists but does not publish: of the 173 price files its indexes named in October 2026, 86 (77 contracts) were not on its server, so those contracts' prices are not shown. Rented network: some SummaCare-administered plans use Ohio Health Choice's PPO network. Those prices are shown as their own network on SummaCare's map and are not part of SummaCare's overall figures; Ohio Health Choice also has its own page.
StateProvidersNamed in filesOrganisationsZip codes Lowest25th pctMedian75th pctHighestvs Medicare
“x Medicare” compares each price with what original Medicare pays a doctor for the same service in the same state under its physician fee schedule (RVU26D, in force from 2026-10-01) — the lower price a doctor is paid when a hospital or surgery center provides the room and equipment. Insurers write their contracts as a share of Medicare, so 1.3x means the insurer pays 30% more than Medicare would; Medicare Advantage plans generally pay close to 1.0x.
This is a statewide summary. Prices vary far more between towns and between practices than these medians suggest; zip-code and provider-level detail is not published here; this specific data can be requested here.