FAQ

How much is an emergency room visit with no insurance

When you or a loved one is very sick, in a lot of pain, or needs immediate medical attention, chances are your first impulse is to visit an emergency room(er).

In this article, I’ll explain when to visit the ER, what the average cost of an ER visit is in each state, and what factors influence the prices of an ER visit.

Reading: How much is an emergency room visit with no insurance

then I will suggest alternatives to an emergency room visit for your urgent health care needs.

Finally, I’ll tell you how to determine if your bill is correct and what you can do to make the cost of an emergency room visit less overwhelming.

when to visit the emergency room

The leading reason for emergency room visits in 2018 was injuries and poisonings, resulting in 10 million hospital admissions out of 20 million visits.

Abdominal pain, acute upper respiratory infection, and chest pain were next in frequency of emergency room visits.

While chest pains might be considered an emergency, the other symptoms most likely can be treated at an urgent care center or by a primary care physician (PCP).

If your condition is life-threatening or causes you extreme pain, it warrants a visit to the emergency room.

If you have a sprained ankle but can still walk with some support, urgent care is probably your best option in terms of time and cost.

Understanding the difference between significant discomfort and serious injury will make it easier to decide where to seek help.

the cost of an emergency room visit

The average cost of different types of illnesses treated in an emergency room varies depending on what is involved in managing the condition and whether tests are needed.

average cost of emergency room visits

In 2019, the average cost of an emergency room visit for an insured patient was $1,082.

Those without insurance spent an average of $1,220.

Average costs may vary by state and disease, but range from $623 to $3,087.

why a visit to the emergency room is so expensive

Emergency rooms are very expensive operations to manage for several reasons.

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for an emergency room to be ready to care for patients with acute medical problems, it is necessary to have many expensive equipment, which requires frequent maintenance to ensure operability, medical supplies, medications and items such as gowns, clothing of bed , beds and monitors.

Secondly, since emergency rooms operate on a 24-hour schedule, they require a lot of staff to keep them in tip-top condition.

That staff includes everyone from maintenance staff to trauma surgeons.

All of these costs are passed on to insurance companies and to patients who visit the ER.

how costs are determined

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In addition to direct care costs, when you check in as an emergency room patient, you are also charged a facility or triage fee.

Beyond that, costs are determined by the hospital, which can vary greatly from place to place.

Some of the cost factors include:

  • supplies used
  • medications administered
  • number of doctors, nurses and ancillary staff caring for you
  • tests required
  • used equipment
  • insurance coverage

    Check with your insurance to see if you have emergency room coverage.

    Even if you have this coverage, you may still have a large bill, which may depend on whether you are seen at an in-network facility and how your insurance plan is structured.

    This situation arises in part due to balance billing.

    Insurance companies negotiate rates with hospitals as they do with all doctors.

    As a result, your insurance may not have a good rate with a hospital you visit, which could affect your bill.

    You’ll also need to meet your deductible before your insurance will cover your visit, so if you have a $2,500 deductible, you’ll have to pay it before the rest of your ER bill is covered.

    alternatives to er

    The emergency room is not your only option when it comes to medical care. consider these alternatives (unless you are facing a medical emergency that requires you to call 911):

    primary care provider

    Your PCP is the best person to see you for all of your health problems that are not life threatening.

    Some pcps may have busy schedules that will require you to wait a few days before seeing them for acute care, but most will be able to prescribe medication or send you to the local urgent care for immediate help.

    also, some pcps have a physician assistant (pa) or nurse practitioner (np) who you can see right away.

    Many also have after-hours advice lines that are covered by ancillary providers or by the provider himself, to help you decide what care you need.

    Scheduling regular yearly checkups with your PCP will help maintain your overall health.

    Your PCP can give you care or help you find the right care for any of your health problems.

    urgent care

    Urgent care can be a good option for uncomfortable conditions that are not life-threatening.

    If you live in or near a suburban or urban area, you should be able to find an urgent care center that is open after hours and on weekends.

    These are some medical problems that can likely be treated at an urgent care center and will help you avoid the expense of visiting an emergency room:

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