Emergency · procedure code 99285

ER visit, severe cost in Gallipolis, OH

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

Metro market

ER visit, severe

Gallipolis, OH · procedure code 99285

Local · metro· n=268Pooled filings, payers not identified
Medicare
$144
25th
$271
Median
$608
75th
$715
90th
$14425th
$271Median
$60875th
$71590th
$170Medicare

Middle price

$271

Half of this market is above it, half below

Middle half spans

$144 to $608

4.2x from low to high

The expensive end

$715

What the priciest providers charge

Medicare reference · Ohio (nearest published locality)

$170

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 $144 to $608, a 4.2x 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 160% of what Medicare pays for the same service at its Ohio 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 $715. 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, though this is a smaller market and we mark it as one. 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, Gallipolis, OH has the 1st highest middle price.

Local · metro
MarketLow endMiddleHigh endProvidersBasis
Gallipolis, OH this page$144$271$608268Local · metro
Columbus, OH$169$169$35318,811Local · metro
Cleveland, OH$144$169$26914,023Local · metro
Cincinnati, OH$144$200$26513,399Local · metro
Dayton, OH$146$178$2255,644Local · metro
Akron, OH$163$169$2384,625Local · 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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