It’s late at night and you feel miserable. You decide to go to your local emergency room instead of urgent care. They run tests, give you meds, and send you on your way.
UC v ER
Then, a month later, you start getting bills — expensive bills. One is from the hospital for thousands of dollars, another is from the lab for a thousand more, and still another comes from the doctor who examined you. That’s when you find out that the doctor was out of network for your insurance.
This scenario may sound far-fetched, but in reality it’s all too common. Being treated at an emergency department is generally far more expensive than going to an urgent care center or a primary care physician. According to a UnitedHealth Group study, going to the ER typically costs about $2,400 more than a trip to urgent care.
What is the average cost of an ER visit?
The average cost for an emergency room visit is $2,600 without insurance, according to UnitedHealthcare. Health System Tracker, a partnership between Peterson Center on Healthcare and Kaiser Family Foundation, recently came out with a report showing a slightly lower average of $2,453.
The amount you pay for an emergency room visit can vary depending on many factors, including:
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Geographic location: The cost of an ER visit will vary depending on what part of the country you’re in. Prices are typically lower in rural areas than in urban ones.
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Time of Day: Emergency visits at night typically cost more than daytime visits due to the cost of staffing.
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Severity of your condition: The more treatments, medications, or services you need, the higher the cost of your ER visit will be.
You’re better off going to an urgent care center or elsewhere for treatment, rather than the ER, unless you’re dealing with one of the following:
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Broken bones
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Chest pain
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Head or neck injury
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Serious burns
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Stroke symptoms
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Uncontrolled bleeding
Keep in mind that this is not a complete list and you should always consult a healthcare professional if you’re unsure about your medical needs.
How much is an ER visit without insurance?
As noted, the average cost for an emergency room visit can be anywhere between $2,400 to $2,600. If you visit the ER without insurance, you could end up paying that entire amount — or more — yourself. According to Health System Tracker, 25% of ER visits cost $3,043 or more. People who have employer health plans still pay, on average, $646 out of pocket for a visit to the ER.
Why are ER bills so high?
Emergency departments charge what’s called a “facility fee.” It’s a price you pay just for walking through the doors to seek help. These fees are coded on a scale of 1 to 5, depending on the seriousness of your medical issue. Health System Tracker report found that facility fees can make up 80% of the total cost of an ER visit.
ER visits are expensive partly because emergency departments are expensive to run. You’re paying for a facility that’s open 24/7 and has supplies and medications at the ready. Also, ER bills can get high because some hospitals don’t contract with private insurance. And even if they do, individual physicians may still be out of network for some patients.
Where should I go for treatment besides the ER?
Knowing where to go for medical care could mean the difference between a $200 bill and a $2,000 one. Here’s a breakdown of what situations are best treated at the ER versus an urgent care clinic, a primary care office, or via a telemedicine appointment, along with the average costs for each.
Urgent care
An urgent care visit costs less than a trip to the emergency room. The average cost for treating a non-emergency condition at a walk-in or urgent care clinic is $185. If you have insurance, it will likely be less, possibly the amount of a co-pay.
If you’re not experiencing a true emergency that needs the ER, but you also can’t wait until Monday morning to call your regular healthcare provider, urgent care can be a good option. Clinics are typically open after hours and on the weekends and can treat non-life-threatening issues like:
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Bladder infections
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Body aches
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Ear infections
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Excessive vomiting or diarrhea
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Migraines
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Minor burns
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Severe sore throat
Primary care
Primary care physicians treat non-life-threatening conditions that are either acute or chronic. Generally, acute conditions like the flu happen suddenly and have rapidly growing symptoms but don’t last more than a few weeks or months. Chronic conditions develop over time and last more than six months. Examples include conditions like asthma or high blood pressure. If you don’t have insurance, your bill at a primary care office might range from around $150 to $450. With insurance, you might spend as little as $15 or $25 for your copay.
Your primary care provider is the best person to see for non-life-threatening health concerns. They can either provide care or help you find the care you need. Many also have out-of-hours phone advice lines to help you decide what care you need if an issue arises at night or on the weekend.
Telemedicine
Telemedicine is perhaps the most economical care option. Services like ours offer online medical visits for a limited number of treatable conditions and provide services like birth control prescriptions. Here are a few other conditions we treat:
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Urinary tract infections
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Acne
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Cold sores
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Hair loss
Free clinics
There are many free, local clinics that provide care to uninsured, underinsured, and medically underserved communities. The National Association of Free & Charitable Clinics can help you find a free clinic in your area.
What if I end up with a high ER bill?
Let’s say you do end up in the emergency room. Here’s what you can do to lower your ER bill:
Question the coding
Remember those high facility fees? Find out what code level your visit was given and challenge it. Also, study your bill closely and make sure you’re not being charged for something that didn’t happen.
Ask for a discount
Your ER bill is negotiable. Ask for a discount based on your age or income, or for paying the entire bill upfront. Don’t take no for an answer. Keep calling and keep trying.
Know your rights
The Emergency Medical Treatment & Labor Act (EMTALA) requires emergency departments to screen and stabilize anyone who needs care, regardless of their ability to pay.
The No Surprises Act, which went into effect on January 1, 2022, is designed to help people avoid unexpected bills when they visit the ER and other medical facilities. Under the Act, people can access emergency care from out-of-network providers without paying extra money for it.
In fact, if you aren’t insured or decide for some reason not to use your health insurance for a service, the law states that, in most cases, you should be able to get a good faith estimate of how much a procedure or treatment will cost before you get it.