Emergency · procedure code 99285

ER visit, severe cost in El Paso, TX

What health plans have contracted to pay providers for Emergency department visit, high severity in the El Paso market, from the machine-readable files those plans publish under federal law. Not billed charges, and not an estimate.

Metro market

ER visit, severe

El Paso, TX · procedure code 99285

Local · metro· n=755Pooled filings, payers not identified
Medicare
$169
25th
$185
Median
$236
75th
$365
90th
$16925th
$185Median
$23675th
$36590th
$169Medicare

Middle price

$185

Half of this market is above it, half below

Middle half spans

$169 to $236

1.4x from low to high

The expensive end

$365

What the priciest providers charge

Medicare reference · Rest Of Texas (nearest published locality)

$169

Performed in an office

Negotiated prices from published filings, reported only where the sample supports it. For your city, not a statewide average. 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 $169 to $236, a 1.4x difference for the same procedure code in the same city. That gap is between contracts, not between quality.

Against Medicare

The middle price sits at 110% of what Medicare pays for the same service at its Rest Of Texas locality. Medicare is a fixed reference line most finance teams already have a feel for, which is why we print it beside every figure. It is not a fair price and not what anything should cost.

The expensive end

One in ten filings sits at or above $365. 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.

Of the 6 markets compared here, El Paso, TX has the 5th highest middle price.

Local · metro
MarketLow endMiddleHigh endProvidersBasis
El Paso, TX this page$169$185$236755Local · metro
Dallas, TX$166$195$3137,957Local · metro
Houston, TX$162$210$2677,856Local · metro
San Antonio, TX$153$188$2472,660Local · metro
Austin, TX$163$189$2602,435Local · metro
McAllen, TX$148$166$193498Local · 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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