Public Health

How Much an ER Visit Costs Without Insurance

Alyssa Orcuilo22 Apr 2021

In the United States, an emergency room visit without insurance can cost anywhere between $150 and $3000. Since the actual price you pay out of pocket will depend on how severe your condition is as well as what diagnostic tests and treatments you undergo, a visit to the emergency room can sometimes exceed these prices.

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Average ER Prices Based on Treatment

The price of your ER visit will depend on what types of treatments and medications you receive. For patients without health insurance, an emergency room visit can cost anywhere between $150 and $3,000. Of course, if the treatment you receive is extensive, an ER visit can exceed this price. For instance, in some cases, especially where critical care is required and/or a procedure or surgery is performed, the cost could reach $20,000 or more.

Average Cost of Common ER Procedures

ServicePrice
Stitches$500
X-ray$260-$460
Chest pain$1,000
Broken bones (including surgery)$10,000

Below is the average price for an ER visit in each state, from lowest to highest. This the out-of-pocket cost with no health insurance coverage, and for a moderate to severe ER visit. 

Average ER Visit Cost by State

StateCostStateCost
Maryland$623.00Indiana$1,618.00
Maine$952.00South Dakota$1,641.00
West Virginia$1,127.00Pennsylvania$1,645.00
Montana$1,138.00New York$1,668.00
Louisiana$1,184.00Missouri$1,717.00
Massachusetts$1,200.00Kentucky$1,740.00
North Dakota$1,245.00Rhode Island$1,750.00
Michigan$1,273.00South Carolina$1,758.00
Kansas$1,294.00New Hampshire$1,787.00
Arkansas$1,304.00Illinois$1,818.00
Iowa$1,377.00Washington$1,841.00
Vermont$1,386.00Nebraska$1,844.00
Wyoming$1,411.00Washington D.C.$1,879.00
Ohio$1,435.00Tennessee$1,883.00
Oregon$1,437.00Virginia$1,941.00
Minnesota$1,462.00Alaska$2,070.00
Utah$1,464.00Hawaii$2,076.00
Oklahoma$1,466.00Idaho$2,159.00
Connecticut$1,493.00Arizona$2,283.00
Alabama$1,496.00Texas$2,318.00
Wisconsin$1,496.00Nevada$2,583.00
New Mexico$1,574.00Colorado$2,886.00
Mississippi$1,583.00California$2,960.00
North Carolina$1,589.00New Jersey$3,087.00
Delaware$1,596.00Florida$3,102.00
Georgia$1,596.00  

Guidelines for Visiting the ER

People visit the emergency room for a wide variety of reasons that can be classified according to different levels of care. Outlined below are some of the most common reasons for visiting the ER. 

  • Chest pain: There are many causes of chest pain. However, chest pain can be associated with a heart attack.
  • Abdominal pain: If you are experiencing extreme or severe abdominal pain, you may consider going to the emergency room.
  • Uncontrolled bleeding: Uncontrolled bleeding is a medical emergency and necessitates an emergency room visit.
  • Changes in vision: Changes in vision require professional medical attention that may include an ER visit. Serious underlying medical conditions can cause sudden vision changes, even if the change is temporary.
  • Coughing or vomiting blood: This can be serious and requires medical attention.
  • Suicidal or homicidal feelings: If you are experiencing suicidal or homicidal thoughts or feelings, you should seek medical attention immediately.

Please note that this list is not comprehensive.

Levels of Emergency Room Care

Normally, emergency room patients receive one of five levels of care. Level 1 care represents the most minor problems treated, whereas Level 5 care represents some of the most severe treatments an ER can provide. While levels of care exist for critically ill patients that are even higher, these levels are used less frequently. 

Emergency Room Care Costs by Levels

LevelDescriptionTypical Cost
1Typically a limited, minor problem that will run its course on its own.$150
2A limited, minor problem with no risk for death, and is not likely to permanently alter a patient’s health status.$400
3A problem where risks are low, and full recovery is expected, but there may be some small risk of problems developing if the patient doesn’t receive treatment.$650
4A severe problem that requires urgent evaluation, but doesn’t pose a threat to life or to physical function; without treatment, there is a high chance of extreme impairment.$870
5An immediate, significant threat to life or physiologic functioning.$1,450

Insurance Coverage for ER Visits

The Affordable Care Act (also known as Obamacare) requires all plans to cover emergency services. Under this legislation, insurers cannot charge you more for going to an out-of-network hospital or health care provider. In addition, insurers cannot require you to get pre-authorization before getting service.

Health insurance plans are typically offered in the following categories: Bronze, Silver, Gold, and Platinum. Each plan will provide varied coverage for healthcare bills.

Coverage Percent by ACA Plan Type

Plan

Percent insurance covers

Percent you pay

Bronze60%40%
Silver70%30%
Gold80%20%
Platinum90%10%

Catastrophic health insurance coverage is also available for individuals under 30 or individuals of any age with a hardship exemption or affordability exemption (based on Marketplace or job-based insurance being unaffordable).

Catastrophic health insurance is a type of health plan that offers coverage in times of emergencies as well as coverage for preventive care.

Factors that Contribute to ER Bills

There are several factors that determine the high costs of ER visits. No sole factor is singularly responsible for the price of an ER visit. Rather, it is the intermingling of each of these factors that contribute to the high costs of an ER visit. 

Costs are Determined Based on the Facility and Location

Every emergency room has various costs for supplies and employees depending on:

  • The staff they are employing
  • The location of the emergency room
  • What kind of supplies they're using

Insurance Coverage

Insurance status and categories greatly influence how much the patient has to pay out-of-pocket. 

For instance, health insurance plans with low monthly premiums may have a cap of around $250 on emergency room expenses. With ER costs ranging from $150-$3000, less extensive insurance plans may only cover the most basic ER visits. 

In addition, patients should also note the “in-network” or “out of network" emergency rooms with your insurance plan. Out of network ERs will not be covered by your insurance plan, and will undoubtedly cost more than in-network ERs. 

You should also note that sometimes there are “out of network” doctors that are working in facilities that are “in-network,” which you might only find out once you get the bill. 

Lack of Price Transparency

Emergency rooms do not provide pricing for services upfront. When you seek care at an emergency room, the medical staff will determine your best care plan. Regardless of the services you are provided (stitches, MRI, prescription medication, etc.), it is likely that you will not know the exact cost of services until after your visit.

Running an emergency room is very expensive

From minor cuts and bruises to MRIs and surgeries, emergencies handle all sorts of medical ailments. Keeping an emergency room open 24/7 with trained and skilled staff has very high costs. 

Along with medical care, emergency rooms have to pay for utility bills such as electricity, water, and food, and supplies. These costs then get passed to the patients. 

Alternatives to the Emergency Room

If you are experiencing a medical emergency that requires immediate attention, you should always seek care from an emergency room.

However, if your situation is not severe and not demanding of immediate medical attention, urgent care may be a better alternative.

Determining whether to go to urgent care or an emergency room can be unclear. Below are a few medical issues that urgent care clinics can treat:

  • Minor fractures
  • X-rays
  • Back pain
  • Nausea, vomiting, and diarrhea
  • Minor headaches
  • Blood work
  • Bumps, cuts, and scrapes
  • Fever

Although going to urgent care is cheaper than the ER, true medical emergencies should always be tended to at an emergency room.

How to Dispute an ER Bill

Multiple factors contribute to the costs of surprise medical bills. Among these factors, the two most common reasons surprise bills exist are claim denials and out-of-network providers. 

Receiving a surprise medical bill can be scary, but you don’t always have to pay for them in their entirety. Here's how you can dispute a surprise emergency room bill.

Bottom Line

As you can see, a trip to the emergency room can really vary in costs by what you’re going for and how long you end up staying. Plus, if you have health insurance with a deductible that isn’t met or insurance that won’t cover certain costs then what you’re actually paying can get very complicated. 

An easier solution for many things people go to an ER for is Mira, where you can be seen by a local urgent care doctor today for as little as $45 per month and $99 per visit. Learn more about how Mira can simplify your health coverage. 

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