Emergency Department Visit with High Level of Medical Decision Making Cost in Pennsylvania
What this costs without insurance: real self-pay cash prices and insurance-negotiated rates at 70 Pennsylvania hospitals. CPT 99285. Sourced directly from each facility's CMS-mandated transparency file. Dataset: Q4 2026.
📊 Median $681
📉 Low $88.74
📈 High $6,180
🏥 70 hospitals
🏛️ 54 with insurance contracts
🇺🇸 Medicare $173
Hospital comparison — Pennsylvania
Sorted by cash price (lowest first). Showing top 60 of 70 hospitals.
Billed more than $681 for this? That gap is evidence.
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| Hospital | Cash | UHC | Aetna | Cigna | Medicare | Medicaid | Humana | BCBS | Molina |
|---|---|---|---|---|---|---|---|---|---|
| AHN SAINT VINCENT HOSPITAL ERIE |
$88.74 | $80.00 | $153 | $281 | $687 | — | $707 | $700 | $727 |
| AHN JEFFERSON HOSPITAL JEFFERSON HILLS |
$93.67 | $80.00 | $166 | $281 | $608 | — | $625 | — | $643 |
| AHN CANONSBURG GENERAL HOSPITAL CANONSBURG |
$108 | $80.00 | $139 | $281 | $608 | — | $625 | — | $643 |
| AHN FORBES HOSPITAL MONROEVILLE |
$108 | $80.00 | $166 | $281 | $608 | — | $625 | — | $643 |
| AHN ALLEGHENY VALLEY HOSPITAL NATRONA HEIGHTS |
$113 | $80.00 | $139 | $281 | $608 | — | $625 | — | $643 |
| AHN GROVE CITY MEDICAL CENTER GROVE CITY |
$113 | $80.00 | $139 | $281 | $608 | — | $625 | — | $643 |
| AHN ALLEGHENY GENERAL HOSPITAL PITTSBURGH |
$118 | $80.00 | $166 | $281 | $625 | — | $625 | — | $643 |
| AHN WEXFORD HOSPITAL WEXFORD |
$128 | $80.00 | $613 | $281 | $608 | — | $625 | — | $643 |
| WEST PENN HOSPITAL PITTSBURGH |
$133 | $80.00 | $166 | $281 | $608 | — | $625 | — | $643 |
| WARREN GENERAL HOSPITAL CRESCENT PARK WEST WARREN |
$136 | $100 | $63.00 | $60.00 | — | — | $101 | $100 | — |
| WELLSPAN YORK HOSPITAL YORK |
$278 | $630 | $301 | $310 | $600 | $200 | — | — | — |
| WELLSPAN YORK HOSPITAL YORK |
$278 | $630 | $301 | $310 | $600 | $200 | — | — | — |
| GUTHRIE ROBERT PACKER HOSPITAL SAYRE |
$324 | — | — | — | — | — | — | — | — |
| GUTHRIE ROBERT PACKER HOSPITAL, TOWANDA CAMPUS TOWANDA |
$324 | — | — | — | — | — | — | — | — |
| GUTHRIE TROY COMMUNITY HOSPITAL TROY |
$324 | — | — | — | — | — | — | — | — |
| BARNES-KASSON COUNTY HOSPITAL SUSQUEHANNA |
$350 | $42.91 | $40.00 | $53.53 | $40.00 | $8.82 | $30.86 | — | — |
| WAYNE MEMORIAL HOSPITAL PARK ST. HONESDALE |
$360 | $70.00 | $75.00 | $70.00 | — | — | $100 | $40.00 | — |
| FULTON COUNTY MEDICAL CENTER PEACH ORCHARD RD. MC CONNELLSBURG |
$365 | $90.00 | $82.60 | $30.80 | $100 | — | $170 | $40.00 | — |
| MERCY FITZGERALD HOSPITAL DARBY |
$367 | — | — | — | — | — | — | — | — |
| ST MARY MEDICAL CENTER LANGHORNE |
$367 | — | — | — | — | — | — | — | — |
| NAZARETH HOSPITAL PHILADELPHIA |
$367 | — | — | — | — | — | — | — | — |
| CONEMAUGH MEYERSDALE MEDICAL CENTER HOSPITAL DRIVE MEYERSDALE |
$383 | $38.00 | $39.52 | $61.60 | — | — | — | $1,025 | — |
| BUCKTAIL MEDICAL CENTER RENOVO |
$401 | — | $194 | $161 | $165 | — | $192 | $348 | — |
| CONEMAUGH MINERS MEDICAL CENTER HAIDA AVENUE HASTINGS |
$524 | $20.00 | $20.80 | $61.60 | — | — | — | $18.56 | — |
| HERITAGE VALLEY BEAVER BEAVER |
$539 | $194 | $139 | $580 | — | — | — | — | — |
| HERITAGE VALLEY SEWICKLEY MCKEES ROCKS |
$539 | $180 | $139 | $580 | — | — | — | — | — |
| LATROBE HOSPITAL LATROBE |
$577 | — | — | — | — | — | — | — | — |
| WESTMORELAND HOSPITAL GREEENSBURG |
$577 | — | — | — | — | — | — | — | — |
| FRICK HOSPITAL MT PLESANT |
$577 | — | — | — | — | — | — | — | — |
| CONEMAUGH NASON MEDICAL CENTER ROARING SPRING |
$582 | $100 | $100 | $595 | $100 | — | $100 | $100 | — |
| LOWER BUCKS HOSPITAL BRISTOL |
$585 | $157 | — | $1,416 | $586 | $139 | $469 | $586 | — |
| SUBURBAN COMMUNITY HOSPITAL NORRISTOWN |
$608 | $157 | — | $1,440 | $609 | $139 | $487 | $609 | — |
| JEFFERSON ABINGTON HOSPITAL ABINGTON |
$672 | $128 | $146 | — | $139 | $50.00 | — | — | — |
| JEFFERSON BUCKS HOSPITAL LANGHORNE |
$677 | $1,917 | — | — | — | $3,709 | — | — | — |
| HOLY REDEEMER HOSPITAL MEADOWBROOK |
$681 | $236 | $643 | $643 | — | — | — | $613 | — |
| JEFFERSON LANSDALE HOSPITAL LANSDALE |
$687 | $1,917 | $1,376 | — | — | $3,709 | — | — | — |
| JEFFERSON TORRESDALE HOSPITAL PHILADELPHIA |
$704 | $1,917 | — | — | — | $3,709 | — | — | — |
| JEFFERSON METHODIST HOSPITAL PHILADELPHIA |
$704 | $2,484 | $1,781 | — | — | $233 | — | — | — |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL PHILADELPHIA |
$704 | $2,484 | $1,781 | — | — | $233 | — | — | — |
| JEFFERSON FRANKFORD HOSPITAL PHILADELPHIA |
$704 | $1,917 | — | — | — | $3,709 | — | — | — |
| MAGEE REHABILITATION HOSPITAL PHILADELPHIA |
$715 | — | — | — | — | $337 | — | — | — |
| INDIANA REGIONAL MEDICAL CENTER INDIANA |
$847 | — | — | — | — | — | — | — | — |
| SURGICAL INSTITUTE OF READING WYOMISSING |
$859 | $1,737 | — | — | — | — | — | — | — |
| CLARION HOSPITAL CLARION |
$867 | $590 | $608 | $590 | $590 | $50.00 | — | — | — |
| CONEMAUGH MEMORIAL HOSPITAL JOHNSTOWN |
$939 | $59.80 | $55.40 | $60.00 | — | — | — | $181 | — |
| PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER CAMP HILL |
$952 | — | — | — | — | — | — | — | — |
| PENN STATE HEALTH ST. JOSEPH MEDICAL CENTER BERNVILLE ROAD READING |
$1,036 | — | — | — | — | — | — | — | — |
| BUTLER MEMORIAL HOSPITAL BUTLER |
$1,084 | $50.00 | $57.50 | $1,348 | $590 | $50.00 | $613 | — | — |
| PENN STATE HEALTH LANCASTER MEDICAL CENTER STATE ROAD LANCASTER |
$1,155 | — | — | — | — | — | — | — | — |
| MOUNT NITTANY MEDICAL CENTER STATE COLLEGE |
$1,245 | $729 | $715 | $715 | — | — | $729 | $744 | — |
| PENN STATE HEALTH HAMPDEN MEDICAL CENTER ENOLA |
$1,254 | — | — | — | — | — | — | — | — |
| PHYSICIANS CARE SURGICAL HOSPITAL ROYERSFORD |
$1,401 | $597 | $597 | $597 | $597 | — | $597 | $597 | — |
| UNIONTOWN HOSPITAL UNIONTOWN |
$1,547 | $577 | $60.00 | $90.00 | $577 | $241 | $606 | $1,060 | — |
| UPMC WELLSBORO WELLSBORO |
$1,558 | — | — | — | — | — | — | — | — |
| PENN MEDICINE DOYLESTOWN HEALTH WEST STATE STREET DOYLESTOWN |
$1,605 | $100 | $68.70 | $47.60 | $100 | — | — | $27.00 | — |
| WELLSPAN EVANGELICAL COMMUNITY HOSPITAL LEWISBURG |
$1,752 | $590 | $590 | — | $590 | $164 | $590 | — | — |
| WELLSPAN GOOD SAMARITAN HOSPITAL LEBANON |
$1,845 | $636 | $624 | $1,250 | $606 | $241 | — | — | — |
| PAM HEALTH SPECIALTY HOSPITAL HERITAGE VALLEY BEAVER |
$2,452 | — | — | — | — | — | — | — | $613 |
| PAM HEALTH SPECIALTY HOSPITAL HERITAGE VALLEY BEAVER |
$2,452 | — | — | — | — | — | — | — | $613 |
| PAM HEALTH SPECIALTY HOSPITAL OF PITTSBURGH STEUBENVILLE PIKE OAKDALE |
$2,453 | — | — | — | — | — | — | — | $711 |
What these prices are. Each figure is the facility’s own published self-pay (cash) price for CPT 99285, filed under the federal price transparency rule (45 CFR Part 180). Hospital facility charges may not include separate physician, anesthesia, or pathology fees. National median for this code: $1,180 across all reporting facilities. Dataset: Q4 2026. Always confirm the final price with the facility before booking.
Billed more than $681 for this?
That is the median of what the 70 Pennsylvania hospitals above publish for Emergency department visit with high level of medical decision making — their own figures, filed under federal law. A bill well above them is evidence you can put in writing.
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Medicare reimbursement benchmark
For CPT 99285 in Pennsylvania, Medicare reimburses about $173 on the 2026 Physician Fee Schedule (non-facility, state average across localities). Hospital cash prices for the same code in Pennsylvania range from $88.74 to $6,180 — that means hospital cash prices are typically 3.9x what Medicare pays. If a self-pay quote you receive is more than 2-3x the Medicare rate, ask the hospital for the cash-discount price in writing.
Frequently asked questions
- How much does emergency department visit with high level of medical decision making cost in Pennsylvania?
- Cash prices for emergency department visit with high level of medical decision making (CPT 99285) in Pennsylvania range from $88.74 to $6,180, with a median of $681. Prices vary widely by hospital.
- Where can I find the cheapest emergency department visit with high level of medical decision making in Pennsylvania?
- The cheapest Pennsylvania hospital published cash price for this procedure is $88.74. Use the table above sorted by cash price to find the lowest-priced facility near you.
- Are these the prices I'll pay?
- These are the rates hospitals publish. Final price depends on your insurance, deductible, and the specific services billed. Always confirm with the facility and your insurer before any procedure.
- Why do prices vary so much between hospitals?
- Hospitals set cash prices independently, and insurance contracts negotiate different rates per payer. Two facilities a few miles apart can charge 5-10x different prices for the same procedure.
- Where does this data come from?
- Federal law (45 CFR § 180) requires hospitals to publish their pricing in a machine-readable file. We aggregate these files and republish in a consumer-friendly format.
Emergency department visit with high level of medical decision making in nearby states
Other procedures in Pennsylvania
Methodology. Cash prices and insurance-negotiated rates published by each Pennsylvania facility under federal price transparency rules (45 CFR § 180). CPT code 99285 (Doctor Visits). Data refreshed regularly; verify with the facility before any procedure.