Emergency · procedure code 99285

ER visit, severe cost in California

No plan has filed Emergency department visit, high severity in Crescent City, CA in a form we can read, so this page shows California instead and says so. These are the rates plans published under federal law. Not billed charges, and nothing here is scaled, adjusted or estimated to stand in for the market we do not hold.

State market

ER visit, severe

CA · procedure code 99285

Statewide· n=92,082Pooled filings, payers not identified

We do not have a publishable distribution for Crescent City, CA, so this is the CA market instead. The label above says so on purpose.

Medicare
$186
25th
$260
Median
$612
75th
$776
90th
$18625th
$260Median
$61275th
$77690th
$172Medicare

Middle price

$260

Half of this market is above it, half below

Middle half spans

$186 to $612

3.3x from low to high

The expensive end

$776

What the priciest providers charge

Medicare reference · Sacramento-Roseville-Folsom (nearest published locality)

$172

Performed in an office

Negotiated prices from published filings, reported only where the sample supports it. Statewide peer distribution, not a single-city sample. What plans have agreed to pay, not what a patient is billed. Filings as of July 20, 2026.

Reading it

What this distribution actually says.

The spread

The middle half of this market runs from $186 to $612, a 3.3x difference for the same procedure code in the same city. That gap is between contracts, not between quality.

Against Medicare

Medicare pays $172 for this service at its Sacramento-Roseville-Folsom locality. We do not turn that into a percentage here, because the price above is California and that Medicare figure is one locality inside it. Two different maps do not divide.

The expensive end

One in ten filings sits at or above $776. If a plan's network is weighted toward that end, the difference does not show up in a premium quote. It shows up in the claims.

How wide the data runs

The carriers that filed for this procedure in this market. What each plan has agreed to pay, side by side. These are prices, not bills, so they do not show how often anyone needs it.

The same service elsewhere

ER visit, severe across other markets.

Local · metro5 of 6 measured locally
MarketLow endMiddleHigh endProvidersBasis
California this page$186$260$61292,082Statewide
Los Angeles, CA$186$189$46634,760Local · metro
San Francisco, CA$195$309$7939,724Local · metro
Riverside, CA$184$189$2776,068Local · metro
San Diego, CA$235$468$69710,765Local · metro
Sacramento, CA$191$572$5845,842Local · metro

Put this in front of a client.

Every figure on this page carries its source, its scope and the date the corpus was built, so it survives being forwarded to someone who was not in the meeting.

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