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Package

Emergency room visit, complex

Package

Emergency room visit, complex

A complex emergency room visit provides immediate care for serious or potentially life-threatening conditions requiring extensive evaluation, multiple diagnostic tests, specialist involvement, or intensive treatment, such as chest pain, stroke symptoms, severe trauma, or significant infection. Upon arrival, a triage nurse will assess your condition and prioritize your care based on severity. These visits often involve a longer stay for monitoring and may result in hospital admission for further treatment. Costs for ER visits vary based on the complexity of care provided.
You'd pay up to
$3,349 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

$3,349

Without insurance

What goes into a price?

Negotiated prices across insurers

Lowest
$779
Highest
$4,934
Cash price
up to $3,349

Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.

Procedures included in this package

This list includes the services and fees bundled into the Emergency room visit, complex Standard Service Package (SSP EM002). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.

Code Code Type Description
HCPCS 96374 Facility Fee Therapeutic IV injection of single substance/drug
HCPCS 85025 Facility Fee Complete blood count (CBC) with differential WBC
HCPCS 81001 Facility Fee Automated urinalysis with dip stick/tablet reagent and microscopy
HCPCS 99285 Facility Fee Ed Visit for Complex Medical Decision-making Involving History/Exam/counseling
HCPCS 99285 Professional Fee Ed Visit for Complex Medical Decision-making Involving History/Exam/counseling
HCPCS 93005 Facility Fee Electrocardiogram (ECG) with recording only, no interpretation
HCPCS 80053 Facility Fee Comprehensive metabolic panel also includes albumin, total protein, ALP, ALT, AST and bilirubin

Disclaimer

Hawaii Health Systems Corporation is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

You'd pay up to
$3,349 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

Disclaimer

Hawaii Health Systems Corporation is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

What’s the difference between an individual procedure and a Standard Service Package (SSP)?

Individual Procedure

Individual procedures, like blood tests, each have unique prices and billing codes (like a CPT or HCPCS code). While they can be billed alone, they're usually grouped with other procedures on a claim. This grouping is what determines the total cost of your care.

Standard Service Package (SSP)

A SSP combines all medical services, materials, and fees associated with a healthcare visit or procedure into a single bundle to offer a more comprehensive estimate.

Contact us to verify your estimate

Have your service name, codes, and payment preference ready. If you’re using insurance, you may be asked for insurance details like your Member or Group ID.

Service Emergency room visit, complex
Service Codes HCPCS 96374, HCPCS 85025, HCPCS 81001, HCPCS 99285, HCPCS 93005
Insurance I'm not using insurance
Location Hilo Benioff Medical Center Main
When you contact us, you can say:
"Hi, I'm calling to verify a price for Emergency room visit, complex I found through Hilo Benioff Medical Center Main's price estimate tool. Here are the codes I’m looking at: HCPCS 96374, HCPCS 85025, HCPCS 81001, HCPCS 99285, HCPCS 93005. I'm not using insurance, can you confirm the cash pay estimate and help me schedule if needed?"
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