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: Wellmark Blue Cross Blue Shield
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: Wellmark Blue Cross Blue Shield lists clinicians individually: 96% of the 41,904 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs. Wellmark Blue Cross Blue Shield’s files name 41,069 providers for this procedure; 13,784 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: Care outside its home state: Blue Cross Blue Shield plans share one national network, BlueCard, for members treated in other states. Those prices are published centrally, not by Wellmark Blue Cross Blue Shield, so they are not included here. Hospital stays: Wellmark Blue Cross Blue Shield's files have no prices for whole hospital stays (the kind billed as one amount per stay), so there are no hospital-stay maps for it. It may pay hospitals by the day or as a share of their charges, which these maps cannot show.
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.