Emergency room visit, complex
What goes into a price?
Negotiated prices across insurers
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 80307 | Facility Fee | Chemistry/chromatography/mass spectrometry to detect any number of drugs using any device/procedure, sample validation if performed |
| HCPCS 93005 | Facility Fee | Electrocardiogram (ECG) with recording only, no interpretation |
| HCPCS J7030 | Facility Fee | Intravenous infusion of 1000cc of normal saline |
| HCPCS 83735 | Facility Fee | Inorganic ionic element essential for body functions |
| HCPCS 71045 | Facility Fee | X-ray of chest for viewing single structure |
| HCPCS 80048 | Facility Fee | Basic metabolic panel including calcium, bicarbonate, chloride, creatinine, glucose, potassium, sodium and BUN |
| HCPCS 96375 | Facility Fee | Subsequent intravenous push of separate substance/drug |
| HCPCS 96365 | Facility Fee | Intravenous drug/substance infusion, initial up to 1 hour |
| HCPCS 85025 | Facility Fee | Complete blood count (CBC) with differential WBC |
| HCPCS 83605 | Facility Fee | Measurement/analysis of blood lactate concentration |
| HCPCS 80076 | Facility Fee | Liver function panel to test liver enzyme activity and protein levels |
| HCPCS 99285 | Facility Fee | Ed Visit for Complex Medical Decision-making Involving History/Exam/counseling |
| HCPCS 84484 | Facility Fee | Quantitative measurement of cardiac muscle protein, troponin |
| HCPCS 36415 | Facility Fee | Collection of blood from a vein via puncture |