It’s true that you can’t plan for a medical emergency, but that doesn’t mean you have to be surprised when it’s time to pay your hospital bill. In 2021, the U.S. government enacted price transparency rules for hospitals in order to demystify health care costs. That means it should be easier to get answers to questions like how much an ER visit costs.
While the question seems pretty straightforward, the answer is more complicated. Your cost will vary based on factors such as if you’re insured, whether you’ve met your deductible, the type of plan you have, and what your plan covers.
There is a lot to consider. This guide will take you through specific scenarios and answer questions about insurance plans, deductibles, co-payments, and discuss scenarios such as how much it costs if you go to the ER when it isn’t an emergency.
You’ll learn a few industry secrets too. Did you know that if you don’t have insurance you might see a higher bill? According to the Wall Street Journal, it’s common for hospitals to charge uninsured and self-pay patients higher rates than insured patients for the same services. So, where can you go if you can’t afford to go to the ER?
Keep reading for all this plus real-life examples and cost-saving tips.
How Much Does an ER Visit Cost Without Insurance?
Everything is more expensive in the ER. According to UnitedHealth, a trip to the emergency department can cost 12 times more than a typical doctor’s office visit. The average ER visit is $2,200, and doesn’t include procedures or medications.
If you want to get a better idea of what an ER visit will cost in your area, check out our medical price comparison tool that analyzes data from thousands of hospitals.
Compare Procedure Costs Near You
Other out-of-pocket expenses you may incur include bills from third parties. A growing number of emergency departments in the United States have become business entities separate from the hospital. So, third-party providers may bill you too, like:
- EMS services, like an ambulance or helicopter
- ER physicians
- Attending physician
- Consulting physicians
- Advanced practice nurses (CRNA, NP)
- Physician assistants (PA)
- Physical therapists (PT)
And if your insurance company fails to pay, you may have to pay these expenses out-of-pocket.
How Much Does an ER Visit Cost With Insurance?
The easiest way to estimate out-of-pocket expenses for an ER visit (or any other health care service) is to read your insurance policy. You’ll want to look for information around these terms:
- Deductible: The amount you have to pay out-of-pocket before your insurance kicks in.
- Copay: A set fee you pay upfront before a covered medical service or procedure.
- Coinsurance: The percentage you pay for a service or a procedure once you’ve met the deductible.
- Out-of-pocket maximum: The most you will pay for covered services in a rolling year. Once met, your insurance company will pay 100% of covered expenses for the rest of the year.
Closely related to out-of-pocket expenses like deductibles and co-insurance are premiums. A premium is the monthly fee you (or your sponsor) pay to the insurance company for coverage. If you pay a higher premium, you’ll have a lower deductible and fewer out-of-pocket costs whenever you use your insurance to pay for services such as a visit to the ER. The opposite is also true — high deductible health plans (HDHP) offer lower monthly payments but much higher deductibles.
Sample ER Visit Cost
Using a few examples from plans available on the Marketplace on Healthcare.gov (current as of November 2021), here’s how this might play out in real life:
Rob is a young, healthy, single guy. He knows he needs health insurance but he feels reasonably sure that the only time he’d ever use it is in case of an emergency. Here’s the plan he chooses:
Plan: Blue Cross/Blue Shield Bronze
Monthly premium: $394
Deductible: $7,000
Out-of-pocket maximum: $7,000
ER coverage: 100% after meeting the deductible
Rob does the math and considers the worst case scenario. If he does go to the ER, he’ll pay full price if he hasn’t yet met his deductible. But since both his deductible and his maximum out-of-pocket are the same, $7,000 is the most he’ll have to pay before his insurance kicks in at 100%.
Now imagine that Rob gets married and is about to start a family. He might need a different insurance plan to account for more hospital bills, doctors appointments, and inevitable emergency room visits.
Since Rob knows he’ll be using his insurance more often, he picks a plan with a lower deductible that covers more things.
Plan: Bright HealthCare Gold
Monthly premium: $643
Deductible: $0
Out-of-pocket maximum: $6,500
ER coverage: $500
Vision: $0
Generic prescription: $0
Primary care: $0
Specialist: $40
This time Rob goes with a zero deductible plan with a higher monthly premium. It’s more out-of-pocket each month, but since his plan covers doctor’s visits, prescription drugs, and vision, he feels more prepared as his lifestyle shifts into family mode.
If he has to go to the ER for any reason, all he’ll pay is $500 and his insurance pays the rest. And worse case scenario, the most he’ll pay out-of-pocket in a year is $6,500.
How Much Does an ER Visit Cost if You Have Medicare?
Medicare Part A only covers an emergency room visit if you’re admitted to the hospital. Medicare Part B covers 100% of most ER costs for most injuries, or if you become suddenly ill. Unlike private insurance and insurance purchased on the Affordable Care Act (ACA) Marketplace, Medicare rarely covers ER visits that happen while you’re outside of the United States.
To learn more, read: How to Use the Healthcare Marketplace to Buy Insurance
How Much Does an ER Visit Cost for Non-Emergencies?
When you have a sick child but lack insurance, haven’t met your deductible, or if you’re between paychecks, just knowing you can go to the ER without being hassled for money feels like such a relief. ER staff won’t demand payment upfront, and they usually don’t ask about insurance or assess your ability to pay until after discharge.
There are other reasons, too. You might be tempted to go to the ER for situations that are less than emergent because emergency departments provide easy access to health services 24/7, including holidays and the odd hours when your primary care physician isn’t available. If you’re one of the 61 million Americans who are uninsured or underinsured, you might go to the ER because you don’t know where else to go.
What you may not understand is the cost of an ER visit without insurance can total thousands of dollars. Consumers with ER bills that get sent to collections face some of the most aggressive debt collection practices of any industry. Collection accounts and charge-offs could affect your credit score for the better part of a decade.
Did you know that charges begin racking up as soon as you give the clerk your name and Social Security number? There are tons of horror stories out there about people receiving medical bills after waiting, some for many hours, and leaving without treatment.
4 ER Alternatives Ranked by Level of Care
First and foremost, if you’re experiencing a medical emergency, call 911 or go to the closest emergency room. Do not rely on this or any other website for advice or communication.
If you’re not sure whether your condition warrants immediate, high-level emergency care, you can always call your local ER and ask to speak to their triage nurse. They can quickly assess how urgent the situation is.
If you are looking for a lower-cost alternative to the ER, this list provides a few options. Each option is ranked by their ability to provide you with a certain level of care from emergent care to the lowest level, which is similar to the routine care you would receive at a doctor’s office.
1. Charitable Hospitals
There are around 1,400 charity hospitals, clinics, and pharmacies dedicated to serving low-income families, including the uninsured. Most charitable, not-for-profit medical centers provide emergency room services, making it a good option if you’re uninsured and worried about accruing substantial medical debt.
ERs at charitable hospitals provide the same type of medical care for conditions like trauma, broken bones, and life-threatening issues like chest pain and difficulty breathing. The major difference is the price tag. Emergency room fees at a charity hospital are usually flexible and almost always based on your income.
2. Urgent Care Centers
Urgent care centers are free-standing facilities designed to treat patients with serious but not life-threatening conditions. Also called “doc in a box,” these ambulatory care centers are a good choice for treating stable but chronic health issues, fever, urinary tract infections, back pain, abdominal pain, and moderately high blood pressure, to name a few.
Urgent care clinics usually have a medical doctor on-site. Some clinics offer point-of-care diagnostic tests like ultrasound and X-rays, as well as basic lab work. The average cost for an urgent care visit is around $180, according to UnitedHealth.
3. Retail Health Clinics
You may have noticed small retail health clinics (RHC) popping up in national drugstore chains like CVS, Walgreens, and in big-box stores like Target and Walmart. The Little Clinic is an example of an RHC that offers walk-in health care services at 190 supermarkets across the United States.
RHCs help low-acuity patients with minor medical problems like sore throat, cough, flu-like symptoms, and other conditions normally treated in a doctor’s office. If you think you’ll need lab tests or other procedures, an RHC may not be the best choice. Data from UnitedHealth puts the average cost for an RHC visit at $100.
4. Telehealth Visits
Telehealth, in some form, has been around for decades. Until recently, it was mostly used to provide access to care for patients living in the most remote or rural areas. Since 2020, telehealth visits over the phone, via chat, or through videoconferencing have become a legitimate and extremely cost-effective alternative to in-person office visits.
Telehealth is perfect for some types of mental health therapies, follow-up appointments, and triage. For self-pay, a telehealth visit only costs around $50, according to UnitedHealth.
Tips for Taking Control of Your Health Care
- Don’t procrastinate. Delaying the care you need for too long will end up costing you more in the end.
- Switch your focus from reactive care to proactive care. Figuring out how to pay for an ER visit is a lot harder (and costlier) than preventing an ER visit in the first place. Data show that preventive health care measures lead to fewer illnesses and better outcomes.
- Plan for the unknown. It’s inevitable that at some point in your life you’ll need health care. Start a savings account fund or better yet, enroll in a health savings account (HSA). If you’re employed (even part-time) you already qualify for an HSA. A contribution of just $9 a paycheck could add up to $468 tax-free dollars for you to spend on health care every year. Unlike the use-it-or-lose-it savings plans of the past, modern plans don’t expire. You can use HSA dollars to pay for out-of-pocket costs like copayments, deductibles, and for services that your health insurance may not cover, like dental and vision services.
- Advocate for yourself. There is nothing more empowering than taking charge of your health. Shop around for services and compare prices on procedures to make sure you’re getting the best prices possible.
- If you are uninsured or doing self-pay, negotiate your bill and ask for a cash discount.
Estimate the Cost of the ER Before You Need It
It’s stressful to think about money when you’re facing an emergency. Research the costs of your nearest ER before you actually need to go with Compare.com’s procedure cost comparison tool.
All you have to do is enter your ZIP code and you’ll immediately see out-of-pocket costs for ER visits at your local emergency rooms. It works for other medical services too, like MRIs, routine screenings, outpatient procedures, and more. Find the treatment you need at a price you can afford.
Compare Procedure Costs Near You
Disclaimer: Compare.com does not offer medical advice and is in no way a substitute for any medical advice received from health professionals. Compare.comis unable to offer any advice on any medical procedure you may need.
FAQs
How much does an ER visit cost? ›
On average, urgent care visits cost between $100 and $200. ER visits can cost upwards of over $1,000 a visit, with an average visit costing between $1,200 and $1,300. The cost of care shouldn't be the only consideration. Time is important, too.
How much is an emergency room visit in California? ›...
Average ER Visit Cost by State.
Why Is My Hospital Bill So Expensive? The cost of US healthcare is soaring. Elements that contribute to the high cost of medical bills include surprise medical bills, administrative costs, rising doctors' fees, the high cost of surgical procedures and diagnostic tests, and soaring drugs costs.
Why don t hospitals post prices? ›The Hospital Price Transparency Law is intended to make the hidden costs of services such as X-rays, medical tests or colonoscopies clear to patients before they enter the hospital.
How much does an ER visit cost in Florida? ›Florida ER visit charges for each hospital in 2019. Find the average cost of an emergency room (ER / ED) visit at each Florida hospital in 2019. State average ER visit cost (charge) was $7,321 (about $68 Billion for over 9.2 million ED visits). Average cost was up about 10.8% from 2018.
How much is an ambulance ride? ›An ambulance ride can cost hundreds or thousands of dollars out of pocket, even with insurance. The average charge for an ambulance ride ballooned 22%, to $1,277, between 2017 and 2020 before insurance or discounts, a study found.
How much is an EKG? ›On average, an EKG costs $205 at urgent care facilities; however, prices can range from about $175 to $299.
What symptoms will get you admitted to the hospital? ›- Difficulty breathing, shortness of breath.
- Chest or upper abdominal pain or pressure.
- Fainting, sudden dizziness or weakness.
- Changes in vision.
- Confusion or changes in mental status.
- Any sudden or severe pain.
- Uncontrolled bleeding.
- Severe or persistent vomiting or diarrhea.
It's Expensive to Run an Emergency Room
hIt cost a lot of money to keep an emergency room open and running at all times with a highly trained, often specialized, paid staff. They have to be ready at all times, for anything and anybody who passes through the door.
- 1) Compare costs online.
- 2) Ask for generic medicines.
- 3) Know Central government's price list for >1700 tests and procedures.
- 4) Ask for a discount.
- 5) Choose an 'Affordable Diagnostic Center'
Do hospitals charge you for watching TV? ›
Hospitals charge patients for TV because the hospital's TV system isn't like a consumer. Most hospitals have smart TV systems with a custom user interface to easily help patients navigate the different services. They also come with multiple subscriptions to cable TV and streaming services.
Where is healthcare free in the world? ›Countries with universal healthcare include Austria, Belarus, Bulgaria, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Isle of Man, Italy, Luxembourg, Malta, Moldova, Norway, Poland, Portugal, Romania, Russia, Serbia, Spain, Sweden, Switzerland, Ukraine, and the United Kingdom.
Do doctors have to tell you price? ›Physicians have responsibility to patients to talk about the cost of care, prescriptions.
What is the best way to compare hospital costs? ›If you have insurance, the best way to find prices is to call your insurance company directly. If you don't, the CDM numbers may be a more accurate representation of what you actually have to pay, but in many cases you can also obtain financial aid from the hospital.
What is the transparency rule? ›The hospital transparency rules require hospitals to publish standard charges for all their services and items and to make the prices for the 300 most common services accessible in a consumer-friendly format. The rule took effect on January 1, 2021 but a year later, just 14% of hospitals were in compliance.
Does Medi cal cover emergency room visits? ›In the event you have a medical emergency before you find a doctor, contact 9-1-1 or go to the emergency room at your nearest hospital. Medi-Cal does cover emergency services for enrolled members, and if you show your BIC to emergency room staff, Medi-Cal will pay for the services you receive.
Is ambulance free in USA? ›It depends on the ambulance company. Some may not charge you unless they provide transportation. Others may charge for being called to the scene, even if you aren't taken to the hospital.
Does Medicaid cover ambulance? ›Florida Medicaid's Covered Services and HCBS Waivers
Medicaid reimburses for medically necessary emergency ground or air ambulance transportation. This service is one of the minimum covered services for all Managed Medical Assistance, Long-Term Care, and Comprehensive Long-Term Care plans serving Medicaid enrollees.
Unless you have a medical card, you may be charged for ambulance services. However, the practice varies between different parts of the country and charges may be waived in certain cases, for example, in cases of hardship. There are a number of private ambulance services, including air ambulance services.
Does Medicare pay for an annual EKG? ›Does Medicare pay for a routine EKG? Medicare will only pay for one screening EKG in your lifetime. To be covered, your doctor must order the EKG as part of your Welcome to Medicare visit.
Is ECG covered by insurance? ›
Generally, insurance will cover 80%-100% of EKG testing. Contact an insurance provider for coverage specifics. Some school athletic programs give student athletes EKGs to test heart health.
What is the difference of EKG and ECG? ›There is no difference between an ECG and an EKG. Both refer to the same procedure, however one is in English (electrocardiogram – ECG) and the other is based on the German spelling (elektrokardiogramm – EKG).
At what pain level should you go to the hospital? ›Any sudden and severe pain is a signal to head to the ER. Sudden and severe pain anywhere in the body is a signal to head to the emergency room. Of most concern is any pain in the abdominal area or starting halfway down the back.
What is the most common reason for hospital admission? ›| Rank | Principal diagnosis | Rate of stays per 100,000 |
|---|---|---|
| 1 | Liveborn | 1,106.5 |
| 2 | Septicemia | 679.5 |
| 3 | Heart failure | 347.9 |
| 4 | Osteoarthritis | 345.5 |
For the most critical medical situations — like a heart attack or stroke — call 911 for an ambulance. You should not drive yourself if you're suffering severe chest pain or impaired vision, bleeding severely or if you might faint.
How many ER visits are unnecessary? ›70% of ER visits unnecessary for patients with employer-sponsored insurance.
Why are hospital bills so expensive in the US? ›The United States healthcare system is complex and most costs are market driven. High, unregulated prescription drug costs and healthcare providers' salaries rank higher than in other western nations, and hospital care accounts for 31% of the nation's healthcare costs.
How can I reduce my out of pocket medical expenses? ›...
Find Affordable Healthcare That's Right for You
- Choose doctors and providers who are in-network. ...
- Utilize telemedicine. ...
- Use a flexible spending account or health savings account.
Many factors go into how and if, a hospital writes off an individual's bill. Most hospitals categorize unpaid bills into two categories. Charity care is when hospitals write off bills for patients who cannot afford to pay.
Do hospitals offer discounts? ›Hospitals provide discount on the check-up fees and procedures, IVF treatment, Cancer treatment, surgeries, ophthalmological procedures, mastectomies and neck dissections, discount on consultation and annual health check-up and policyholder can avail discount on the hospital room charges and operation charges.
How much do hospitals sell for? ›
How much is your hospital worth? Take a look at some hospital acquisition transactions from Levin Associates. Based on the two examples they give, the ballpark going rate for a typical, profitable hospital is $200,000 to $250,000 per bed. Put another way, hospitals are worth ~60 - 80% of their annual revenues.
When did hospitals get TVS? ›In- deed, television arrived in U.S. hospitals at the same time that the standards set forth by Hill-Burton Act were materializing and just years before both the Civil Rights Act of 1964 and the Medicare legislation of 1965.
How much did Oakville hospital cost? ›The new Oakville Trafalgar Memorial Hospital is 1.6 million square feet and was built at a cost of $2.7-billion.
What state has the best free healthcare? ›Hawaii is the top state for health care. It's followed by Massachusetts, Connecticut, New Jersey and California to round out the top five. Learn more about the Best States for health care below.
Which country has the best doctors? ›1. United States: On our list of the top ten nations with the best doctors in the world, the United States earns the top spot.
Which country has the best surgeons? ›| Rank | Country | Specialist Surgical Team Members per 100,000 people |
|---|---|---|
| 1 | Monaco | 278 |
| 2 | Cayman Islands | 172 |
| 3 | Colombia | 162 |
| 4 | Austria | 141 |
The physician is often the best person to initiate the cost discussion, says Zafar, because they are responsible for the treatment plan. But other team members can sometimes help as well.
How much is an emergency room visit San Francisco? ›In the San Francisco area, the fees tend to be about 20 percent higher, likely reflecting the higher cost of living in the area. There, the fees range from $326 to $1,713. But at Zuckerberg San Francisco General, the fees ranged from $463 to $9,853, and often made up a significant portion of patients' bills.
Which of the following is an effective tool for collecting a patient's payment for health care services? ›1. Software payment integration. Many RCM services and financial/practice management systems allow you to integrate credit card and ACH payments directly into the patient's account ledger by processing the card with the payment amount posting in real-time.
What is the best way to compare hospital costs quizlet? ›What is the best way to compare hospital costs? On the basis of individual assessment of cost for inpatient and outpatient services.
How can I know that I am getting the hospital with the best outcomes? ›
Talk to your doctor and other health care providers about the quality of care at hospitals. Some hospitals have more experience or better results treating certain conditions or performing certain procedures. Ask your doctor or health care provider which hospital has the best care and results for your condition.
How often is care compare update? ›Care Compare data are refreshed on a quarterly basis for certain Inpatient measures.
What is the final rule in healthcare? ›The final rule requires that women be treated equally with men in the health care they receive and also prohibits the denial of health care or health coverage based on an individual's sex, including discrimination based on pregnancy, gender identity, and sex stereotyping.
What does CMS stand for? ›The Centers for Medicare & Medicaid Services, CMS, is part of the Department of Health and Human Services (HHS).
What is the Transparency in coverage rule 2022? ›However, that enforcement delay period ends this month, and as of July 1, 2022, the Coverage Rule requires that health plans and health insurance issuers must publicly disclose pricing information for covered items and services in specified formats for plan or policy years beginning on or after January 1, 2022.
How much does the NHS cost per person? ›How much does the UK spend on health care compared to other countries? Public spending on health care in the UK totalled £177bn in 2019 (the last year for which we have comparable international data), which equates to £2,647 per person for the year.
Do I have to pay for A&E? ›Treatment in A&E departments, at GP surgeries and under the Mental Health Act remains free for all.
How much does the NHS cost? ›The central administration budget for NHS England in 2022/23 has been set at £608 million. Our programme costs are focused on the delivery of our corporate priorities and this year we have a funding envelope of £2.5 billion.
What illness costs the NHS the most? ›The cost of prescribing medication to people with diabetes in general practice has risen and remains the largest area of spending, according to analysis by Cogora.
What is the best healthcare system in the world? ›- Denmark.
- Austria.
- Japan.
- Australia.
- France.
- Spain.
- Belgium.
- United Kingdom.
Can you just walk out of A and E? ›
We do not offer an out-of-hours walk-in service; referrals should be made by your GP, optician or other health care provider. If you are not currently under the care of the Royal Free Ophthalmology service you cannot refer yourself.
Where is healthcare free in the world? ›Countries with universal healthcare include Austria, Belarus, Bulgaria, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Isle of Man, Italy, Luxembourg, Malta, Moldova, Norway, Poland, Portugal, Romania, Russia, Serbia, Spain, Sweden, Switzerland, Ukraine, and the United Kingdom.
What does free at the point of use mean? ›In practice, "free at the point of use" normally means that anyone legitimately and fully registered with the system (i.e., in possession of an NHS number), available to legal UK residents regardless of nationality (but not non-resident British citizens), can access the full breadth of critical and non-critical medical ...