emergency room visit price

How much does an ER visit cost?

$1,500 – $3,000 average cost without insurance (non-life-threatening condition), $0 – $500 average cost with insurance (after meeting deductible).

Average ER visit cost

An ER visit costs $1,500 to $3,000 on average without insurance, with most people spending about $2,100 for an urgent, non-life-threatening health issue. The cost of an emergency room visit depends on the severity of the condition and the tests, treatments, and medications needed to treat it.

Cost data is from research and project costs reported by BetterCare members.

Emergency room visit cost with insurance

The cost of an ER visit for an insured patient varies according to the insurance plan and the nature and severity of their condition. Some plans cover a percentage of the total cost once you meet your deductible, while others charge an average co-pay of $50 to $500 .

The No Surprises Act , effective January 1, 2022, protects insured individuals from unreasonably high medical bills for emergency services received from out-of-network providers at in-network facilities. The act also established a dispute resolution process for both insured and uninsured or self-pay individuals.

Cost of an ER visit without insurance

An ER visit costs $1,500 to $3,000 on average without insurance for non-life-threatening conditions. Costs can reach $20,000+ for critical conditions requiring extensive testing or emergency surgery. Essentially, the more severe your condition or issue, the more you are likely to pay for the ER visit.

Factors that impact ER visit costs

Many factors affect the cost of an ER visit, including:

Facility type – Freestanding emergency departments often cost 50% more than hospital-based emergency rooms.

Time of day – An ER visit at night typically costs more than the same type of visit during the day.

Level of care – The more severe your condition is, the more time and expertise it takes to diagnose and treat, and the higher the total ER visit cost.

Ambulance ride – An ambulance ride costs $500 to $1,300 on average, depending on whether you need basic or advanced life support during transport.

Medications – Oral medications, injections, or IVs needed during your stay all add the total cost of your ER visit.

Medical equipment & supplies – Any other supplies used to diagnose and treat you—such as a cast for a broken bone or bandages and sutures to close an open wound—increase the cost.

Testing – Each medical test is typically a separate charge. Tests may include urine tests, blood tests, X-rays, or other more advanced imaging tests.

Insurance coverage:

Out-of-pocket costs may be higher for those with high-deductible insurance plans.

While ER visit costs are generally higher for the uninsured, many hospitals offer discounts for self-pay patients.

ER facility fee by level

An ER facility fee ranges from $200 to $4,000 , depending on the severity level of your symptoms and condition. The facility fee is the cost to walk in the door and be evaluated by a physician. Other services you may need, such as lab tests, imaging, and surgical procedures, are charged separately.

To understand your ER bill: Emergency rooms rank severity levels 1 through 5, with Level 1 being the most severe or urgent. However, most of the billing codes for emergency room visits are reversed, with level 1 being the least severe.

Common conditions and procedures

The table below shows the average ER visit cost for common ailments. Prices vary greatly depending on how much testing and expertise is required to accurately diagnose and treat you.

Emergency room vs. urgent care

An ER visit costs $1,500 to $3,000 , while the average urgent care visit costs $150 to $250 without insurance. Urgent care facilities can treat most non-life-threatening conditions and typically have less wait time than the ER. For more detail, check out our guide comparing the cost of an emergency room vs. urgent care .

Other alternatives to the ER for less serious health issues include primary care, telemedicine, and free clinics. Check with the National Association of Free and Charitable Clinics to find a free clinic near you.

FAQs about ER visit costs

Why are er visits so expensive.

ER visits are expensive because emergency rooms run on a 24-hour schedule and require a large and wide range of staff, including front desk personnel, maintenance, nurses, doctors, and surgeons. ERs also run and maintain a lot of expensive equipment and need a constant supply of medications and medical supplies.

While ER visits can be expensive, ER bills are negotiable. If you receive an unexpectedly large ER bill, ask for a discount and question the coding.

Does insurance cover ER visits?

Insurance typically covers some or all of an ER visit, though you may need to meet a deductible first, depending on the plan. The Affordable Care Act requires insurance providers to cover ER visits for "emergency medical conditions" without prior authorization and regardless of whether they are in or out-of-network.

An "emergency medical condition" is considered something so severe that a reasonable person would seek help right away to avoid serious harm.

When should you go to the ER?

You should go to the ER for any serious, potentially life-threatening symptoms, including:

Trouble breathing

Serious head injury

Sudden severe pain

Severe burn

Severe allergic reaction

Major broken bones

Uncontrollable bleeding

Suddenly feeling weak or unable to move, speak, or walk

Sudden change in vision

Sudden confusion

Fever that does not resolve with over-the-counter medicine

Tips to reduce your ER bill

An ER visit can cost thousands of dollars, even if you have insurance. Here are some guidelines to ensure you are not overpaying:

Determine if you truly need an emergency room. If your health issue is not life threatening, consider going to an urgent care facility instead as the cost for the same care can be much less.

Go to a hospital-based ER. Freestanding ER centers typically cost much more than a hospital-based emergency room.

Call ahead to confirm payment options and the current wait time.

Ask about costs up front. If you are uninsured, consider asking the following questions to prevent you from surprises on your future bill:

Do you have discounted pricing for patients without insurance?

Will it cost less if I pay with cash?

What will the fee be for my specific issue?

Do you think I will need additional tests, and what will they cost?

How much do you charge for X-rays?

If I need medication, how much will it cost?

Using our proprietary cost database, in-depth research, and collaboration with industry experts, we deliver accurate, up-to-date pricing and insights you can trust, every time.

• An emergency room visit typically is covered by health insurance. For patients covered by health insurance, out-of-pocket cost for an emergency room visit typically consists of a copay, usually $50-$150 or more, which often is waived if the patient is admitted to the hospital. Depending on the plan, costs might include coinsurance of 10% to 50%.
• For patients without health insurance, an emergency room visit typically costs from $150-$3,000 or more, depending on the severity of the condition and what diagnostic tests and treatment are performed. 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. For example, at Park Nicollet Methodist Hospital in Minnesota, a low-level emergency room visit, such as for a minor laceration, a skin rash or a minor viral infection, costs about $150 ; a moderate-level visit, such as for a urinary tract infection with fever or a head injury without neurological symptoms, about $400 ; and a high-level visit, such as for chest pains that require multiple diagnostic tests or treatments, or severe burns or ingestion of a toxic substance, about $1,000, not including the doctor fees. At Dartmouth-Hitchcock Medical Center[ 1 ] , a low-level emergency room visit costs about $220, including hospital charge and doctor fee, with the uninsured discount, while a moderate-level visit costs about $610 and a high-level visit about $1,400 .
• Services, diagnostic tests and laboratory fees add to the final bill. For example, Wooster Community Hospital, in Ohio, charges about $170 for a simple suture, $200 for a complex suture, about $170 for a minor procedure and about $400 for a major procedure, not including doctor fees, medicine or supplies.
• A doctor fee could add hundreds or thousands of dollars to the final cost. For example, at Grand Lake Health System[ 2 ] in Ohio, an emergency room doctor charges about $100 for basic care, such as a wound recheck or simple laceration repair; about $300 for mid-level care, such as treatment of a simple fracture; about $870 for advanced-level care, such as frequent monitoring of vital signs and ordering multiple diagnostic tests, administering sedation or a blood transfusion for a seriously injured or ill patient; and about $1,450 for critical care, such as major trauma care or major burn care that could include chest tube insertion and management of IV medications and ventilator for a patient with a complex, life-threatening condition. At the Kettering Health Network, in Ohio, a low-level visit costs about $350, a high-level visit costs about $2,000 and critical care costs almost $1,700 for the first hour and $460 for each additional half hour; ER procedures or surgeries cost $460-$2,300 .
• According to the U.S. Agency for Healthcare Research and Quality[ 3 ] the average emergency room expense in 2008 was $1,265 .
• According to the U.S. Centers for Disease Control and Prevention, in 2008, about 18%of emergency room patients waited less than 15 minutes to see a doctor, about 37%waited 15 minutes to an hour, about 15% waited one to two hours, about 5% waited two to three hours, about 2% waited three to four hours, and about 1.5% waited four to six hours.
• In some cases, the doctor might recommend the patient be admitted to the hospital. The American College of Emergency Physicians Foundation offers a guide[ 4 ] on what to expect.
• An ambulance ride typically costs $400-$1,200 or more, depending on the location and services performed.
• An urgent care center offers substantial savings for more minor ailments. DukeHealth.org offers a guide[ 5 ] on when to seek urgent care. An urgent care visit typically costs between 20% and 50% of the cost of an emergency room visit. MainStreetMedica.com offers a cost-comparison tool for common ailments.
• Hospitals often offer discounts of up to 50% or more for self-pay/uninsured emergency room patients. For example, Ventura County Medical Center[ 6 ] in California offers ER visits, including the doctor fee and emergency room fee but not including lab tests, X-rays or procedures, for $150 for patients up to 200% of the federal poverty level, for $225 for patients between 200% and 500% of the federal poverty level and $350 for patients from 500% to 700% of the federal poverty level.
• The American College of Emergency Physicians Foundation offers a primer[ 7 ] on when to go to the emergency room.
• In most cases, it is recommended to go to the nearest emergency room. The U.S. Department of Health and Human Services offers a hospital-comparison tool[ 8 ] that lists hospitals near a chosen zip code.
•   patients.dartmouth-hitchcock.org/billing_questions/out_of_pocket_estimator_dhmc.ht...
•   www.grandlakehealth.org/index.php?option=com_content&view=article&id=106&Itemid=60
•   meps.ahrq.gov/mepsweb/data_stats/tables_compendia_hh_interactive.jsp?_SERVICE=MEPS...
•   www.EmergencyCareforYou.org/VitalCareMagazine/ER101/Default.aspx?id=1288
•   www.dukehealth.org/health_library/health_articles/wheretogo
•   resources.vchca.org/documents/SELF%20PAY%20DISCOUNT%20GRID%20-%20BOARD%20LETTER%20...
•   www.EmergencyCareforYou.org/YourHealth/AboutEmergencies/Default.aspx?id=26018
•   www.medicare.gov/hospitalcompare/(S(efntd2saaeir2l5pgarwuvvg))/search.aspx?AspxAut...

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Emergency Room Visit: When to Go, What to Expect, Wait Times, and Cost

Knowing when and why to go for an emergency room visit can help you plan for care in the event of a medical emergency.

How much does it cost to go to an emergency room?

Emergency Room (ER) costs can vary greatly depending on what type of medical care you need. How much you pay for the visit depends on your health insurance plan. Most health plans may require you to pay something out-of-pocket for an emergency room visit. A visit to the ER may cost more if you have a High-Deductible Health Plan (HDHP) and you have not met your plan’s annual deductible. HDHP's typically offer lower monthly premiums and higher deductibles than traditional health plans. Your plan will start paying for eligible medical expenses once you’ve met the plan’s annual deductible. Here are some tips to pay less out of pocket .

When should I go to an emergency room?

Emergency rooms are often very busy because many people don’t know what type of care they need, so they immediately go to the ER when they are sick or hurt. You should make an emergency room visit for any condition that’s considered life-threatening.

Life-threatening conditions include, but are not limited to, things like a serious allergic reaction, trouble breathing or speaking, disorientation, a loss of consciousness, or any physical trauma.

If you need to be treated for problems that are considered non-life threatening, such as an earache, fever and flu symptoms, minor animal bites, mild asthma, or a mild urinary tract infection, consider seeing your doctor or visiting an urgent care center or convenience care clinic.

What is the cost of an emergency room visit without insurance?

Emergency room costs with or without health insurance can be very high. If you have health insurance, review your plan documents for details on the costs associated with your plan, including your plan deductible, coinsurance, and copay requirements.

If you don’t have insurance, you may be required to pay the full cost of your treatment, which can vary by facility and the type of treatment required. Always plan ahead for sudden sickness, injury, or other medical needs, so you know where to go and how much it could cost. If you need medical care, but it’s not life-threatening you may not have to go to the ER—there are other more affordable options:

• Urgent care center: Staffed by doctors, nurses, and other medical staff who can treat things like earaches, urinary tract infections, minor cuts, nausea, vomiting, etc. Wait times may be shorter and using an urgent care center could save you hundreds of dollars when compared to an ER.
• Convenience care clinic: Walk-in clinics are typically located in a pharmacy (CVS, Walgreens, etc.) or supermarket/retail store (Target, Walmart, etc.). These clinics are staffed with physician assistants and nurse practitioners who can provide care for minor cold, fever, flu, rashes and bruises, head lice, allergies, sinus/ear infections, urinary tract infections, even flu and shingles shots. No appointments are needed, wait times are usually minimal, and a convenience care clinic costs much less than an ER.

Plan ahead for when you need medical care. You may not need an emergency room visit and the bill that could come with it.

What are common emergency room wait times?

Emergency room wait times vary according to hospital and location. Patients in the ER are seen based on how serious their condition is. This means that the patients with life-threatening conditions are treated first, and those with non-life threatening conditions have to wait.

To help reduce ER wait times, health care facilities encourage you to plan ahead for care, so when you’re sick or hurt, you know if the ER is right for your medical condition.

An emergency room visit can take up time and money if your problem is not life-threatening. Consider other care options, such as an urgent care center, convenience care clinic, your doctor, or a virtual doctor visit (video chat/telehealth)—all of which could be faster and save you money out of your own pocket if the medical problem is non-life threatening.

If you have health insurance, be sure to check your plan documents to see what types of care options are eligible for coverage under your plan, including whether or not you need to stay in your plan’s network.

Is taking an ambulance to the emergency room free?

An ambulance ride is not free, but your insurance may cover some of the costs for the ride, as well as the emergency room visit. Check your plan benefits to see what out-of-pocket expenses you are responsible for when it comes to an ambulance ride and a visit to the ER.

Plan ahead for times you may need immediate medical care. Review the details of your health plan so you know the costs for an ER visit should you ever need it. Know when it’s best to go to the emergency room and when going somewhere else, like an urgent care center, convenience care clinic, your doctor, or even a virtual doctor visit (video chat/telehealth), is the right option that may save you time and money.

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Why An ER Visit Can Cost So Much — Even For Those With Health Insurance

Terry Gross

Vox reporter Sarah Kliff spent over a year reading thousands of ER bills and investigating the reasons behind the costs, including hidden fees, overpriced supplies and out-of-network doctors.

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

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What are my care options and their costs?

When you or a family member needs care, there may be more options than you realize. Some options may save you time — others may save you money, particularly if you get health insurance through work. So, before you spend time waiting in the emergency room (ER) or maybe end up with an unexpected bill, consider these alternatives that could save you up to $2,500. 1

Compare your care options

Primary care provider, average cost.

$170 1   for in-person visits,  $99  or less for virtual primary care visits

Hours open:

Weekday office hours, generally

Usually little wait with scheduled appointments

Your primary care provider may know your history best, they can quickly access your records and may offer in-person and  virtual care .

• Urinary tract infection

Sign in to find care

24/7 virtual visits.

Less than  $49 2

Available all day, every day

Usually no wait

Connect with a care provider by phone 3  or video for diagnosis of common medical conditions and, if needed, Rx prescriptions.

• Cold and Flu
• Sinus problems
• Yeast infections

Convenience care clinic

Nights and weekends, generally

30 minutes or less on average

Get care for common symptoms from nurse practitioners and physician assistants — without an appointment — at retail pharmacy clinics.

• Minor injuries

Urgent care center

Get walk-in care for serious illnesses and severe injuries from physicians and care teams.

• Muscle sprains or strains
• Skin infections
• Broken bones

Emergency Room

Available 24 hours a day, generally

Up to 2 hours on average

Get immediate care for life-threatening injuries or illnesses from physicians and care teams at hospital emergency departments.

• Shortness of breath
• Major burns
• Severe injuries
• Heavy bleeding

Choose network care providers to help avoid cost surprises

Freestanding emergency rooms, also called urgency centers, are facilities typically unattached or unaffiliated with a hospital. Although these facilities treat many of the same conditions as a traditional ER, they may come with higher costs because they're out of network.

Get a closer look at your care options

Watch a video presentation to get details about:

• Care options
• Costs for care
• How to choose care

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Access & Affordability

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Emergency department visits exceed affordability threshold for many consumers with private insurance

By Hope Schwartz Twitter ,  Matthew Rae Twitter ,  Gary Claxton ,  Dustin Cotliar,  Krutika Amin , and  Cynthia Cox Twitter

December 16, 2022

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Introduction

The high cost of emergency care may impact patients’ ability to afford treatment , with almost half of US adults reporting they have delayed care due to costs. Almost 1 in 10 Americans have medical debt , and about half of American households do not have the liquid assets to afford an average employer sponsored plan deductible. More than one third of US adults are unable to afford a $400 medical expense without borrowing.

Costs of medical emergencies present an additional financial burden on top of already costly health insurance premiums ranging $1,327 for single coverage and $6,106 for family coverage, on average, for workers with employer sponsored insurance. Variation in emergency department billing may make it difficult to predict the cost of an emergency department visit and subsequent financial liability. Recently, the No Surprises Act legislation aimed to curb unexpected emergency medical costs by prohibiting out-of-network billing for emergency services.

In this analysis, we use 2019 insurance claims data from the Merative MarketScan Commercial Database, which captures privately insured individuals with large employer health plans. We look at the total and out-of-pocket costs of emergency department visits for this group, overall and by diagnosis and severity level. We also look at which services contribute most to the costs of emergency department visits and examine regional variation in emergency department costs. Finally, we look at the demographic profile of consumers who visited the emergency department and the relationship between emergency department spending and annual spending for enrollees.

We find that enrollees spend $646 out-of-pocket, on average, for an emergency department visit. Enrollees with high annual health spending were more likely to visit the emergency department; the majority of enrollees in the top 10% of annual health care spending had at least one emergency department visit during the year. The most expensive components of most emergency department visits include evaluation and management charges, imaging, and laboratory studies, and facility fees make up 80% of the cost of visits. Cost varies by disease, visit complexity, and geographic region.

Large employer plan enrollees’ emergency department visits cost $2,453, on average, with enrollees responsible for $646 in out-of-pocket costs

On average, enrollees in large employer health plans who have an emergency department visit spend $646 out-of-pocket on the visit. There is significant variation in emergency department spending, with 25% of visits costing over $907 out-of-pocket and another quarter costing less than $128 out-of-pocket. These out-of-pocket costs for a single emergency department visit may be more than some people with private insurance can afford and, in some cases, could entirely deplete a consumer’s savings. For example, about 1-in-5 people (21%) with private insurance living in single-person households have less than $1,000 in liquid assets.

Related Content:

The burden of medical debt in the United States

How financially vulnerable are people with medical debt?

These amounts only include out-of-pocket spending required by the insurer. Before the No Surprises Act went into effect in January 2022, privately insured patients who visited the emergency department frequently had out-of-network claims on their visit, putting them at risk of providers sending them surprise balance bills. The No Surprises Act now prohibits most surprise out-of-network billing, but does not apply to ground ambulances . Any balance bill that a patient received from a provider would not appear in claims data and therefore would have been in addition to the out-of-pocket amounts shown here.

In total, enrollees and insurers paid $2,453, on average, per visit, with one quarter of visits costing $970 or less and another quarter costing $3,043 or more. All the costs described in this analysis are for the emergency department visits only, including professional services and facility fees, and do not include any spending on subsequent hospitalizations.

Facility fees contribute significantly more than professional fees to total visit cost

Emergency department bills are categorized as facility fees or professional fees. Professional fees are for services provided by clinicians, and facility fees include bills for services rendered using equipment owned by the facility, including laboratory or imaging studies. These fees are considered “overhead” for emergency departments and help facilities maintain appropriate staffing levels and technical resources. Evaluation and management charges also have a facility fee component for the equipment, staffing, and administrative resources used by the physician in their management. We find that facility fees make up 80% of total visit cost.

Evaluation and management charges make up the largest share of costs

Including both the professional fee and facility fee components of charges, the largest contributor to spending on a typical emergency department visit is the evaluation and management charge, which accounts for almost half (44%) of average visit costs. Evaluation and management charges are bills for the assessment of a patient that are not related to specific procedures or treatments provided; these services cost over $1,100 per visit, on average.

Imaging charges, including radiologist interpretation fees, make up an additional 19% of the average emergency department visit charge and cost $483, on average. The highest cost routinely performed imaging services include x-rays of the chest and CT scans of the head, chest, abdomen, and pelvis. Over half of visits (55%) include a charge for imaging services. About half of patients (49%) are charged for laboratory studies, including blood tests, which cost $230 on average. Other high cost but less common charges include surgical charges for patients with appendicitis and other conditions requiring surgery without inpatient admission, as well as ambulance charges for transport.

Heart attacks and appendicitis among the most expensive common conditions treated in the emergency department

Costs of emergency department visits depend on diagnosis. We selected nine common reasons to visit the emergency department that vary in complexity of management. More severe conditions, or those with more intervention required, are the most expensive. Of the nine specific diagnoses that we evaluated, the lower-cost diagnoses were those that generally do not require imaging or extensive treatment in the emergency department. These included upper respiratory tract infections ($1,535 total, $523 out-of-pocket), skin and soft tissue infections ($2,005 total, $572 out-of-pocket), and urinary tract infections ($2,726 total, $683 out-of-pocket). While these diagnoses can occasionally require admission to the hospital, in otherwise healthy adults they are typically evaluated with basic laboratory studies and discharged with prescriptions.

The most expensive emergency department diagnosis among those we examined is appendicitis, which, on average, costs $9,535 ($1,717 out-of-pocket) per visit. Appendicitis is almost two times as expensive as the next most expensive diagnosis we looked at, heart attack. 11% of enrollees with a diagnosis of appendicitis had surgical charges associated with their emergency department visit. Surgical costs may be included in emergency department outpatient billing because these patients are often discharged after surgery without being admitted to the hospital. In contrast, other emergency department visits requiring surgery are often admitted to the hospital and have surgical charges during their inpatient visit. Enrollees who had surgery had more expensive visits by over $2,000 compared to those who did not; however even without surgery, visits for appendicitis were almost four times as expensive as the average emergency department visit (and more than twice as expensive out-of-pocket).

Enrollees with emergency department visits have variable annual spending depending on diagnosis

In addition to the costs of the emergency department visit itself, enrollees who visit the emergency department at least once during the year have higher annual health care spending. Annual spending includes the cost of all claims for each patient in 2019, either before or after their emergency department visit. Though appendicitis was the most expensive emergency department visit among the diagnoses we analyzed, enrollees with appendicitis in 2019 incurred an average of $24,333 in additional health care spending, which was comparable to lower cost diagnoses. Enrollees with heart attacks had at least two times more annual spending than any other diagnosis ($52,993), while enrollees with upper respiratory tract infections had the lowest annual spending ($13,727).

These differences in annual costs may reflect spending both directly related and unrelated to the emergency department visit. For example, enrollees with heart attack emergency department visits may have high annual spending because of follow-up, medications, or hospitalizations after their heart attacks. However, their high annual spending may also reflect more comorbidities and higher healthcare utilization at baseline. In contrast, appendicitis, the most expensive emergency department visit, is correlated with relatively lower annual costs; unlike heart attacks, appendicitis often occurs in younger, healthier people and requires comparatively little additional post-surgical follow-up or treatment.

The most complex emergency visits are more than 6 times as expensive as the least expensive visits, but insurers pay an increasing share of the visit as complexity increases

Emergency department visits are coded by complexity during the billing process, from 1 (least complex) to 5 (most complex). Each evaluation and management charge is associated with a procedure code ranging from level 1 to level 5 (99281 to 99285), which are generated by hospital coding professionals based on the physicians’ medical note. Criteria are defined by the Centers for Medicare and Medicaid Services ( CMS ) and based on the complexity of documentation and medical decision making. Patients with level 1 complexity codes require straightforward medical decision making, with self-limited or minor presenting problems, such as rashes or medication refills. Patients with level 5 codes require high complexity medical decision making and present with life- or limb-threatening conditions, such as severe infections or cardiac arrests.

The lowest complexity visits cost $592 on average, with enrollees responsible for $205, or about one-third of the total visit cost. As visits increase in complexity, both out-of-pocket costs and costs covered by insurance increase. For the highest complexity visits, the health plan covers $3,015 on average, or eight times the cost of the lowest complexity visits. On average, patients pay $840 out-of-pocket for the highest complexity visits, which is four times their out-of-pocket costs for the lowest complexity visits.

Higher complexity visits are more expensive for multiple reasons. In general, evaluation and management charges are higher cost for more complex patients. Also, patients with more complex medical conditions generally receive more diagnostic tests, medication, and other treatment, which increases the cost of the visit. For the lowest complexity visits, evaluation and management charges account for almost half (47%) of the overall visit cost. In contrast, evaluation and management charges for the highest complexity visits account for about one-fourth (27%) of the total visit cost, with additional services including tests and treatment making up a larger share of the cost.

Emergency department costs vary by geographic region

We analyzed the top 20 metropolitan statistical areas (MSAs) by population, where data are available. Overall, the San Diego, CA area had the most expensive average ED visits ($3,761 on average). San Diego ED visits were more than twice as expensive as Baltimore, MD, the least expensive MSA in our analysis ($1,645 on average). Expensive MSAs were geographically distributed in all regions of the country including the South, West, Northeast, and Midwest. Within each MSA, there was significant variation in visit costa. For example, 25% of visits in Oakland, CA cost less than $1,236 on average, while 25% cost more than $4,436 on average.

Some variation may be based on the distribution of diagnoses in each area, with more serious or complex diagnoses leading to higher cost visits. For example, if a metro area sees higher than average volume of appendicitis, heart attacks, or other high-cost diagnoses, that would drive up regional emergency department costs.

For common diagnoses, Texas and Florida MSAs are among the most expensive

If we examine costs for specific diagnoses, we can minimize some of this variation in reasons for visits and gain a better understanding of how prices and service intensity affect the rankings. We selected two common, moderate-cost reasons for emergency department visits: low back pain and lower respiratory infections. While these visits can range in complexity and treatment required, they usually do not require hospital admission or high-cost treatment. Low back pain includes patients who present with the symptom of low back pain, regardless of diagnosis. Lower respiratory tract infection includes infectious causes of pneumonia and bronchitis. This analysis was limited to MSAs in which there were >500 cases of each diagnosis in 2019.

Visit costs for both diagnoses in Dallas, TX, Houston, TX, Fort Worth, TX, and Orlando, FL are in the top five most expensive MSAs with >500 cases. For low back pain visits, the Orlando, FL, Fort Worth, TX, Dallas, TX, and Houston, TX areas are each more than twice as expensive as the Warren, MI and Detroit, MI areas, on average. This trend is similar for lower respiratory tract infections. Within MSAs, variation in costs exist for both diagnoses. For example, for low back pain visits, there is more than a $3,000 difference between the least expensive and most expensive quarter of visits in Fort Worth, TX, Dallas, TX, and Houston, TX.

12% of large employer group enrollees went to the emergency department in 2019

We find that 12% of large group enrollees under age 65 had at least one emergency department visit in 2019, and of enrollees with emergency department visits, 80% had only one visit. 20% had more than one visit, and 7% had more than two visits. Emergency department visits were associated with higher annual health care spending, with almost half of enrollees in the top 25% of annual spending having at least one emergency department visit during the year.

We find that the average emergency department visit exceeds the threshold that some consumers can pay without borrowing, and even one emergency department visit in a year may create financial hardship for enrollees in large employer plans. For example, one quarter of emergency department visits for large employer enrollees cost over $907 out-of-pocket. Meanwhile, about 1-in-5 people with private insurance do not have $1,000 in liquid assets, and almost half of US adults report that they would not be able to pay a $500 medical bill without going into debt. Emergency department visits range significantly in cost depending on diagnosis, visit complexity, and geographic area. These variations may present challenges for consumers trying to predict the cost of their emergency department visit prior to going to the emergency department.

Several factors contribute to the variability of emergency department charges. First, unlike other forms of outpatient care including primary care or urgent care visits, emergency departments charge facility fees to offset the cost of keeping emergency departments open and staffed 24/7. These fees vary widely and are increasing at a faster rate than overall health care spending. The facility component represented 80% of total emergency department spending in our analysis. Many hospitals and health care providers consider these costs necessary given their mandate to provide emergency triage and treatment to allcomers. A second contributor to variation is that services are often billed at different complexity levels, and visits that are billed as more complex are more expensive . In some cases, even similar services are billed at different prices by different facilities. Notably, surprise out-of-network medical bills from emergency departments have contributed to high emergency costs for consumers, though the cost of any balance bills would be outside the scope of our claims data. The implementation of the No Surprises Act in January 2022 will generally curb surprise medical billing for emergency care.

As seen in non-emergency spending , we find that emergency department costs vary by geographic area. Among the most expensive MSAs in our analysis were MSAs located in Texas, Florida, California, Colorado, and New York. Interestingly, the most expensive regions for ED care do not align with the most expensive regions for overall health care spending. These comparisons suggest that our findings are not solely related to overall high health care prices in these areas and may reflect other factors including the age and medical complexity of the population or differences in local norms and practice patterns. State-level emergency department regulation may also play a role—states with higher numbers of freestanding , non-hospital affiliated emergency departments (which are associated with higher spending on emergency care) were among the most costly in our analysis.

The financial implications of visiting the emergency department vary widely. Not all the variation in total charges is reflected in out-of-pocket costs, since differences in cost by complexity level are smaller after insurance covers its portion of the bill. However, the most complex emergency department visits have four times higher out-of-pocket costs than the least complex visits. Even the least complex visits, some of which could be treated by a primary care office or urgent care center, cost an average of $205 out-of-pocket ($592 total). Given facility fees and relatively high evaluation and management charges in emergency departments, insurers and patients are paying more when receiving care for these conditions at emergency departments than they would using primary or urgent care. These lower complexity visits may represent a substantial avoidable cost to patients and the health care system at large.   

High health care costs are of foremost concern for US adults, leading people to skip recommended medical treatment or delay necessary care. Even in the era of new price transparency regulation , which aims to improve consumer access to prices for elective care, emergency department consumers often do not know what testing or treatment they will need, so it is difficult to assess the costs of a visit upfront. Further, in an emergency situation, patients may not be able to choose their provider or facility if they are brought in by ambulance or otherwise unable to direct their care. Lastly, lack of availability and standardization in data may make it difficult for patients to use price transparency data in real time to make decisions about accepting tests and treatment in an emergency. The high and variable cost of emergency department visits represents an opportunity for future policy changes to protect consumers from unaffordable medical bills.

This analysis is based on data from the Merative MarketScan Commercial Database, which contains claims information provided by a sample of large employer plans. Enrollees in MarketScan claims data were included if they were enrolled for 12 months. This analysis used claims for almost 14 million people representing about 17% of the 85 million people in large group market plans (employers with a thousand or more workers) from 2004-2019. To make MarketScan data representative of large group plans, weights were applied to match counts in the Current Population Survey for enrollees at firms of a thousand or more workers by sex, age, state, and whether the enrollee was a policy holder or dependent.

Emergency department visits were flagged if an enrollee had an emergency department evaluation and management claim in the emergency department or the hospital on a given day. If an enrollee had either an emergency evaluation and management claim or another claim originating in the emergency department on the day prior to or after the flagged day, we added the previous and or following day’s outpatient spending to the visit cost. This was to capture all emergency department services for visits that may have spanned overnight or multiple days. Over half (53%) of the spending in this analysis occurred in the emergency department, with another 42% occurring in the hospital, which may occur when a patient receives a test or procedure in a location outside the emergency department during their visit.

Claims were included if they were above $100 and below the 99.5 th percentile of cost. Selected conditions were generated from a literature review of common emergency department diagnoses and defined using ICD10 codes. Enrollees were considered to have a certain diagnosis if the relevant ICD10 code appeared in the “Diagnosis 1” column in one or more claims on an emergency department visit day. While emergency department claims have up to four diagnoses, diagnoses listed in 2-4 were not used to identify relevant conditions because these diagnoses were most often incidentally found rather than related to the reason for presenting to the emergency department. For specific diagnosis definitions: Heart attack includes acute STEMI and NSTEMI, and excludes complications from prior heart attacks or angina; UTI includes acute cystitis, UTI and pyelonephritis; Kidney stone includes renal calculus in any location and renal colic; Lower respiratory infection includes pneumonia and bronchitis. Surgical charges for acute appendicitis include both open and laparoscopic surgical charges. Annual spending was defined as the total spending for each enrollee in the year 2019, which could occur before and/or after their emergency department visit depending on the time of year of the emergency department visit.

This analysis has some limitations. First, there is a chance that we could incorrectly include non-emergency outpatient care (such as a next-day, follow up primary care appointment) in our estimate of emergency department visit costs. Secondly, when accounting for annual spending, we do not control for health status prior to the emergency department visit. Therefore, the increase in annual health spending for patients who visit the emergency department for certain conditions may be because these patients are sicker and higher healthcare utilizers at baseline, rather than specific follow-up costs incurred for the emergency department visit itself. For selecting relevant diagnoses, we only include claims in which a particular diagnosis occurs as the primary diagnosis. Third, the MarketScan database includes only charges incurred under the enrollees’ plan and do not include balance billing to enrollees which may have occurred. Lastly, our findings only represent enrollees in large group employer sponsored plans and may not be generalizable to other groups.

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Emergency department services

Medicare Part B (Medical Insurance)  usually covers emergency department services when you have an injury, a sudden illness, or an illness that quickly gets much worse.

Your costs in Original Medicare

• You pay a  copayment for each emergency department visit and a copayment for each hospital service you get.
• After you meet the Part B deductible , you also pay 20% of the  Medicare-Approved Amount  for your doctor's services.
• If your doctor admits you to the same hospital for a related condition within 3 days of your emergency department visit, you don't pay the copayment(s) because your visit is considered part of your inpatient stay.   

Find out cost

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

• Other insurance you may have
• How much your doctor charges
• If your doctor accepts assignment
• The type of facility
• Where you get your test, item, or service

Things to know

Medicare only covers emergency services outside of the U.S. under rare circumstances.

Related resources

• Ambulance services
• Find hospitals
• Inpatient hospital care
• Outpatient hospital services

Is my test, item, or service covered?

Why Did My Emergency Room Visit Cost So Much?

Emergency room visits are notoriously expensive. Just a few hours in the ER can cost you thousands of dollars, with or without insurance.

But how is your ER visit cost calculated, and how can you tell whether your hospital bill is correct? 

We scored some insider tips from Goodbill medical coding expert Christine Fries, who has analyzed thousands of ER hospital bills for accuracy. Here are answers to frequently asked questions we get from Goodbill customers about how to understand and vet ER visit costs.

Why did I get 2 bills for my ER visit?

Patients are usually surprised when their first ER hospital bill is quickly followed by a separate hospital bill with similar-sounding charges but different amounts. This is normal and a byproduct of how hospitals bill patients for the services rendered at the hospital, Fries says. 

The institutional bill, also known as the facility bill, charges you for the procedures, tests, and administrative costs from the hospital. 

The professional bill, also known as the physician bill, charges you for the work and time of the physician who treated you. This generally includes services from doctors, anesthesiologists, or specialists who are affiliated with the hospital but aren’t employed by the hospital. 

Expect to get two bills from your ER visit — one for facility charges, and the other for professional or physician charges.

For more information on the different types of hospital bills, see our itemized bill guide . Goodbill currently helps patients negotiate institutional bills, not professional bills, so our guidance below pertains to institutional bills only. 

My diagnosis turned out to be minor. Why was I charged so much?

It’s important to remember that your ER visit costs are based on the symptoms you first describe upon entering the hospital, not your eventual diagnosis, Fries says.

When a patient walks into the emergency room complaining of chest pains, for example, the hospital’s objective is to run tests and administer procedures that can help rule out life-threatening conditions. Even if the doctor ends up discharging the patient with a non life-threatening diagnosis like indigestion, the hospital has already spent the resources to rule out more severe possibilities like a heart attack.

Your ER visit costs are based on the symptoms you first describe upon entering the hospital, not your eventual diagnosis.

“Look at your symptoms first, not what you were diagnosed with,” Fries says. “The level of your ER visit is guided by the symptoms you described, and by the tests the hospital thought were needed based on those symptoms.”

Why was I charged for an ‘ER Visit Level’ 3, 4, or 5? Is this based on severity?

Hospitals will bill you for a line item called “ER Visit Level” that is based on the complexity of your treatment. ER visit levels range from 1-5: ER visit level 1 is the most mild, while ER visit level 5 is the most severe. The level also determines how much the hospital can charge you, from least expensive to most expensive. You may sometimes hear ER visit levels described by their corresponding Current Procedural Terminology (CPT) codes of 99281, 99282, 99283, 99284 and 99285. 

To decide the proper ER visit level, hospitals typically follow certain guidelines from the American College of Emergency Physicians (ACEP) . ER level 1-2 visits are reserved for treatment of mild cases like bug bites and sunburns. The majority of ER visits fall between ER visit levels 3-5, with ER visit level 4 being the most common, Fries says.

“Most emergency room claims will qualify as a 99284, because you only need something as simple as IV fluids to get you there,” Fries says.

The majority of ER visits fall between ER visit levels 3-5, with ER visit level 4 being the most common.

Here’s a simple rule of thumb for determining whether your ER visit level was correctly assigned.

ER Visit Level 4

‍ An ER visit level 4 typically requires a minimum of two diagnostic tests — like a lab plus an EKG, or a lab plus an X-ray. Or, any administration of fluids through IV will automatically qualify your visit as an ER visit level 4.

ER Visit Level 5

‍ An ER visit level 5 typically requires a minimum of three diagnostic tests — for example, a lab plus EKG and X-ray. Or, any type of imaging scan like a CT scan or MRI where a patient must ingest or be injected with contrast material, will automatically qualify your visit as an ER visit level 5.

‍ I’m not pregnant. Why did I get charged for a pregnancy test?

Many female patients get frustrated when they’re charged for a pregnancy test, even when they’re absolutely certain they’re not pregnant. But this is standard practice and a way for hospitals to protect against unknown pregnancies, Fries says. 

If you’re an adult pre-menopausal female, you can count on being asked to do a urine or blood pregnancy test before the hospital will treat you. It’s too risky to both the patient and hospital to administer injections, scans or drugs in the off chance that a patient is unknowingly pregnant. 

If you're a female, expect to get a pregnancy test during your ER visit — even if you're not pregnant.

On your itemized ER bill, your pregnancy test will usually show up with a description like “human chorionic gonadotropin (hCG),” which is the hormone being tested. This charge will generally fall under the CPT codes 84702 or 84703 if it’s a blood test, or 81025 if it’s a urine test. 

What are some other common ER services I might see on my hospital bill? 

Here are a few common procedure names that often show up in your ER visit costs, and what they mean in plain English:

Metabolic panel

‍ This is a bundle of lab tests run from a single blood draw. Patients may get a “basic” metabolic panel under CPT code 80048, or a “comprehensive” metabolic panel under CPT code 80053. These panels cover a set of individual tests that might otherwise be individually charged. For example, a “comprehensive” metabolic panel must include testing for all of the following: 

• Carbon dioxide
• Phosphatase, alkaline
• Transferase, alanine amino
• Transferase, aspartate amino
• Urea nitrogen

Venipuncture

‍ Any time you get your blood drawn through a needle, this charge under CPT code 36415 is the line item that bills you for the needle.

‍ This test under CPT code 83690 measures your levels of lipase, which is an enzyme that helps break down fat in your intestines. Your lipase levels may be elevated if you have pancreatitis, which is an inflammation of the pancreas gland.  

What are some ER visit cost errors I should look out for?

When analyzing a patient’s ER visit costs for errors, Fries says she goes straight to one place first: Hydration services. If you recall being administered fluids through an IV bag, chances are you got hydration services during your ER visit.

“Hydration services should always be questioned,” Fries says.

Coding guidelines require that the two CPT codes for this service, 96360 and 96361, meet a minimum time requirement of 31 minutes in order for one unit to be billed. These 31 minutes must also be “stand alone” — meaning that the administration of the service cannot overlap with any other type of infusion service. Often, hospitals don’t meet these requirements, rendering the charge unbillable.

Hydration services are a common source of errors in ER hospital visit costs. You can tell if you're being overcharged by checking your medical record.

To verify whether you’re being charged properly, you’ll need your medical record, Fries says. Look for hydration service “start” and “stop” times, which are usually included in the Medication Administration Report (MAR) section of your record. If the hydration service duration is less than 31 minutes of standalone time, you have a strong case to dispute the charge with your hospital. To find out how to get your medical records online, visit our Medical Records guide .

I don’t see any CPT codes on my bill. How can I get them?

CPT codes are the common language used across all hospitals to describe a certain procedure. They’re what enables our medical coders at Goodbill to analyze hospital bills for errors, line item by line item. They also help us compare prices apples-to-apples across hospitals.

CPT codes are the standard language used to describe a certain procedure across all hospitals. They're key to helping you identify errors or inflated charges in your ER hospital bill.

Unfortunately, the hospital bill you get in the mail is most likely a consolidated summary of your ER visit costs and won’t include CPT codes. You’ll need an “itemized bill” from your hospital to get a line-by-line breakdown of each charge, complete with the CPT code and cost. 

The good news is that you’re legally entitled under HIPAA to get access to this information. To learn more about your patient rights and how to obtain your itemized bill, check out our Patient Right of Access guide .

Are there other topics you’d like us to cover? Email us at [email protected] and let us know.

Guides, news, and articles to help you tackle hospital bills.

How to Negotiate Your Hospital Bill

Read our expert tips on how to negotiate your hospital bill to save up to thousands of dollars.

Itemized Bill: Your Key to Negotiating

Itemized bills provide key details that can help you negotiate your hospital bill.

Can Hospital Bills Affect My Credit?

You have time before your bill can go to collections or affect your credit.

Negotiating hospital bills has never been this easy.

Building trust and confidence into every health care transaction.

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Urgent Care Visit Cost: Insurance vs. No Insurance

Due to lower costs and convenience, urgent care centers and stand-alone health clinics are becoming more popular. As of 2019, across the United States, there were around 9,616 urgent care centers . But what do they treat at an urgent care clinic ? How much does it cost compared to going to the ER? What if you don’t have insurance? We’ll cover these questions and more, plus offer cost-saving advice.

What is Urgent Care?

Healthcare .gov defines urgent care as “Care for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe it requires emergency room care.”

In other words, it’s the middle ground between assessing bug bites and performing surgery. Urgent care centers provide relief without the wait or expense of going to your hospital’s emergency department. 

Urgent Care Visit vs. Emergency Room Visit

Hospital emergency rooms are usually busier and always more expensive than urgent care centers . The cost of an ER visit varies, but the average cost is around $1,200. So when you can’t see your primary care physician or normal health care provider , a trip to urgent care is usually the most cost-friendly move.

Typical urgent care services include minor medical treatments that you can get at the doctor’s office such as:

• Urinary tract infections
• Upper respiratory infections
• Sore throat  
• Strep throat
• STD treatment and diagnosis

When should you go to the ER ? 

• Chest pain and other signs of a heart attack
• Problems breathing
• Weakness or numbness on one side
• Slurred speech
• Serious burns
• Head injury
• Broken bones
• Dislocated joints

Types of Procedures Offered at Urgent Care Facilities  

Besides physical exams, urgent care may provide the following procedures: 

• Minor surgical procedures (stitches, mole removal, cauterization, incision and drainage, cyst extraction, fingernail or toenail removal)
• Pap smear testing
• STD testing
• Pregnancy tests
• Blood tests (complete blood count, metabolic panels, enzymes, cholesterol, triglyceride)
• Flu tests and COVID-19 tests

Interested in learning more about procedure costs? Use this price comparison tool to quickly access the costs of these procedures (and lots of others) from providers in your area. 

Compare Procedure Costs Near You

How Much Does a Trip to Urgent Care Cost if You Have Insurance?

All ACA-compliant health insurance plans cover emergency care, though not all insurers define what emergency care is in the same way. So, most insurance plans cover urgent care , and your out-of- pocket costs will likely be cheaper than an ER visit.

Most insurance plan providers encourage the use of urgent care clinics during off-hours, weekends, and holidays — when you can’t see your regular doctor — by charging fees and copays similar to an office visit with a primary care provider. However, some plan providers, like TRICARE, only allow you to visit urgent care clinics that are within your network up to two times each year without prior authorization. 

The typical copay for urgent care is between $25 and $50. Your insurance company sets the rates, and they may vary. 

The average out-of- pocket costs for an urgent care visit if you have insurance breaks down like this: 

Copay and/or coinsurance + deductible (if applicable) = out-of- pocket costs

To find out exactly how much you will have to pay, consult your health insurance plan policy’s explanation of benefits (EOB).

How Much Does Urgent Care Cost for Uninsured Patients ?

In the United States, 5.4 million laid-off workers became uninsured between February and May 2020, an increase that is 39% higher than any other in modern history. 

The average cost of an urgent care visit is $100 to $200, according to American Family Care, the largest urgent care clinic in the United States.

Depending on your medical needs , this could be much higher. Procedures like lab tests and X-rays will increase the amount of your final bill.

Urgent Care Alternatives

Many people go to the ER for simple medical care when they are between paychecks or have a high deductible insurance plan, because an emergency department (unlike urgent care) is obligated to provide care to all patients regardless of their ability to pay. 

If you fall into this category or have no insurance , the following urgent care alternatives may fit your needs:

• Free clinics: Many communities offer free or low-cost health care clinics. The cost of using these clinics usually depends on your income or ability to pay. State and local health departments also offer deeply discounted services similar to urgent care clinics . Additionally, there are around 1,400 charity hospitals and clinics across the United States. 
• Retail health clinics: Chains like CVS and Walgreens, as well as big-box stores like Target and Walmart, offer minor medical care via retail health clinics (RHC). RHCs offer walk-in health care services in select stores across the United States. The average cost for treatment at an RHC is around $100.
• Telehealth: This is one of the most budget-friendly ways to access health care today. According to United Healthcare , the average cost for telehealth, currently around $50, is about 50% less than most urgent care visit costs. You don’t need to have insurance to use telehealth either. CVS offers telehealth visits via the Minute Clinic .

How to Save on Your Urgent Care Visit Cost

If you are covered by insurance, make certain to go to an urgent care clinic that accepts your specific insurance plan . Calling your provider is the best way to avoid the unhappy surprise of unmet urgent care costs. 

If you’re wondering how you can save money on your out-of- pocket costs , you have a few options. For one, many urgent care clinics offer discounted rates of up to 20% off when you pay in cash. And you can always visit Aunt Bertha , the website that connects you with partners in your area. Their mission is to provide community support, including financial help for medical bills, prescriptions, copays , and deductibles . 

Sometimes when you have to go to an urgent care center , you don’t have time to worry about the costs of tests and procedures. But when possible, looking up prices on Compare.com puts you in control of your health care , helping you make better, more informed decisions.  

Disclaimer: Compare.com does not offer medical advice and is in no way a substitute for any medical advice received from health professionals. Compare.com is unable to offer any advice on any medical procedure you may need.

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24-Hour Emergency Care

Our emergency department team is here for your emergencies around the clock.

Gritman’s emergency services are always open and ready to handle a wide range of medical and trauma cases. If you have a medical emergency, please call 911.

Our emergency physicians, nurses and technicians have all gone through extensive training to provide immediate, comprehensive and sophisticated emergency care. We accept all patients, regardless of ability to pay.

When You Arrive

For you or your loved one to get checked in as quickly as possible, a staff member will ask for the patient’s full name and date of birth. More registration information will be gathered later in the visit after the patient has been seen by a clinical staff member.

With wait times well below the national average, our emergency staff sees that each patient is assessed and taken to a room as quickly as possible. If you are able, please bring a list of current medications.

Transfer to Another Hospital

In rare situations, we may transfer a patient to another hospital for a higher level of care. Our doctors and staff work closely with specialists in Spokane, Coeur d’Alene and other hospitals as required. These hospitals often receive patients needing critical, specialized attention. Common reasons for transfer include emergent cardiac catheterization, advanced treatment for stroke and complex trauma cases.

Our emergency department is directly connected by elevator to our state-of-the-art helipad. If air ambulance services are required, helicopters are able to quickly and safely move the patient to another facility.

We cannot diagnose or give medical advice over the phone. If you have questions about a medical condition, please contact your physician or visit the Emergency Department in person.

Gritman Achieves Level IV Trauma Care Designation

State-level certification validates exceptional emergency care.

Patients enter the Gritman Emergency Department knowing they can receive an exceptional level of care.

Such high standards have also been validated by the state of Idaho Time Sensitive Emergency System (TSE) , which has granted Gritman Level IV Trauma Certification for the care provided by our Emergency Department.

When Minutes Matter

How fast action and a clot-busting drug saved a patient.

Tom Newhof was surprised by the expression on his wife’s face as he tried to tell her his right arm was numb.

“She had this horrified look because what was coming out of my of mouth was alphabet soup,” Tom said.

Read Tom’s Experience

Did you or a loved one have an amazing experience at Gritman? Share your experience !

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Healthcare in Moscow – Personal and Family Medicine

Emergency : 112 or 103

Obstetric & gynecologic : +7 495 620-41-70

About medical services in Moscow

Moscow polyclinic

Emergency medical care is provided free to all foreign nationals in case of life-threatening conditions that require immediate medical treatment. You will be given first aid and emergency surgery when necessary in all public health care facilities. Any further treatment will be free only to people with a Compulsory Medical Insurance, or you will need to pay for medical services. Public health care is provided in federal and local care facilities. These include 1. Urban polyclinics with specialists in different areas that offer general medical care. 2. Ambulatory and hospitals that provide a full range of services, including emergency care. 3. Emergency stations opened 24 hours a day, can be visited in a case of a non-life-threatening injury. It is often hard to find English-speaking staff in state facilities, except the largest city hospitals, so you will need a Russian-speaking interpreter to accompany your visit to a free doctor or hospital. If medical assistance is required, the insurance company should be contacted before visiting a medical facility for treatment, except emergency cases. Make sure that you have enough money to pay any necessary fees that may be charged.

Insurance in Russia

Travelers need to arrange private travel insurance before the journey. You would need the insurance when applying for the Russian visa. If you arrange the insurance outside Russia, it is important to make sure the insurer is licensed in Russia. Only licensed companies may be accepted under Russian law. Holders of a temporary residence permit or permanent residence permit (valid for three and five years respectively) should apply for «Compulsory Medical Policy». It covers state healthcare only. An employer usually deals with this. The issued health card is shown whenever medical attention is required. Compulsory Medical Policyholders can get basic health care, such as emergencies, consultations with doctors, necessary scans and tests free. For more complex healthcare every person (both Russian and foreign nationals) must pay extra, or take out additional medical insurance. Clearly, you will have to be prepared to wait in a queue to see a specialist in a public health care facility (Compulsory Medical Policyholders can set an appointment using EMIAS site or ATM). In case you are a UK citizen, free, limited medical treatment in state hospitals will be provided as a part of a reciprocal agreement between Russia and UK.

Some of the major Russian insurance companies are:

Ingosstrakh , Allianz , Reso , Sogaz , AlfaStrakhovanie . We recommend to avoid  Rosgosstrakh company due to high volume of denials.

Moscow pharmacies

A.v.e pharmacy in Moscow

Pharmacies can be found in many places around the city, many of them work 24 hours a day. Pharmaceutical kiosks operate in almost every big supermarket. However, only few have English-speaking staff, so it is advised that you know the generic (chemical) name of the medicines you think you are going to need. Many medications can be purchased here over the counter that would only be available by prescription in your home country.

Dental care in Moscow

Dentamix clinic in Moscow

Dental care is usually paid separately by both Russian and expatriate patients, and fees are often quite high. Dentists are well trained and educated. In most places, dental care is available 24 hours a day.

Moscow clinics

«OAO Medicina» clinic

It is standard practice for expats to visit private clinics and hospitals for check-ups, routine health care, and dental care, and only use public services in case of an emergency. Insurance companies can usually provide details of clinics and hospitals in the area speak English (or the language required) and would be the best to use. Investigate whether there are any emergency services or numbers, or any requirements to register with them. Providing copies of medical records is also advised.

Moscow hosts some Western medical clinics that can look after all of your family’s health needs. While most Russian state hospitals are not up to Western standards, Russian doctors are very good.

Some of the main Moscow private medical clinics are:

American Medical Center, European Medical Center , Intermed Center American Clinic ,  Medsi , Atlas Medical Center , OAO Medicina .

Several Russian hospitals in Moscow have special arrangements with GlavUPDK (foreign diplomatic corps administration in Moscow) and accept foreigners for checkups and treatments at more moderate prices that the Western medical clinics.

Medical emergency in Moscow

Moscow ambulance vehicle

In a case of a medical emergency, dial 112 and ask for the ambulance service (skoraya pomoshch). Staff on these lines most certainly will speak English, still it is always better to ask a Russian speaker to explain the problem and the exact location.

Ambulances come with a doctor and, depending on the case, immediate first aid treatment may be provided. If necessary, the patient is taken to the nearest emergency room or hospital, or to a private hospital if the holder’s insurance policy requires it.

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Every year we host more and more private tours in English, Russian and other languages for travelers from all over the world. They need best service, amazing stories and deep history knowledge. If you want to become our guide, please write us.

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[email protected]

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We created ReadyCare to further strengthen our commitment to becoming a health partner for our community.

Readycare provides our community with much needed access to same-day, non-emergent, minor care services., readycare hours of operation, 7:00am – 12:00pm, 1:00pm – 4:00pm, 9:00am – 3:30pm, wait times may vary, please plan accordingly.

Our ReadyCare team always strives to deliver outstanding patient care in a timely manner; however, due to the nature of the types of patient concerns we see in ReadyCare, and dependent on patient volume, there may be a longer than normal wait to be seen.

Please be patient with us if you experience a longer wait than expected, and remember that there is an emergency department downstairs if your issue is more emergent.

Please allow enough time to be seen. Coming to the clinic close to closing time may result in our inability to provide same day services to you.

Do I Need ReadyCare?

Wondering If ReadyCare Is Right For You?

ReadyCare is for acute and minor illness and injuries. If you are unsure if ReadyCare would be appropriate for your health concern, one of our clinic staff may be able to assist you! Call the ReadyCare line directly at 509-332-8847.

Please note that we are unable to provide medical advice over the phone. If you are a patient of Palouse Medical, please call the main line at 509-332-2517 , and leave a message for your primary care provider.

For any other recommendations, we suggest coming by the office during ReadyCare hours and one of our clinical team members can triage your symptoms.

What Concerns Are Better Treated Elsewhere?

When using ReadyCare, please be aware that we may need to triage your health concern to determine if our minor care clinic is the best place for you to receive the care that you require. There are many variables that contribute to whether or not a minor care clinic is the most appropriate place to be treated for a medical concern.

It is important to remember that some health concerns cannot be properly addressed or treated in this setting and sometimes your care may require or be better suited for:

• An appointment with your primary care provider Some health concerns need to be addressed with a primary care provider who will be able to provide you with the follow up care that you require. Good examples of these types of concerns are chronic health conditions or if you are in need of medication refills.
• The Emergency Department Emergency rooms have immediate access to diagnostic equipment and technologies that our minor care clinic doesn’t have available. Other medical issues are beyond the scope of minor care. We want you to get the care you need.

Who Can Use ReadyCare?

You don’t have to be a current Palouse Medical patient to use ReadyCare. It is open to patients of all ages, whether you are a resident or visitor.

Do I Need An Appointment?

Do I Need an Appointment? Can I Call Ahead and Reserve My Spot?

ReadyCare is walk-in only. We assist patients based on a “first come, first served” waiting queue model. You must be present in the clinic in order to add yourself on the list.

• It is always our goal to deliver the highest quality of professional health care within a timely fashion to our patients. Please be aware that dependent on patient volume or the nature of the visits ahead of you, varying waiting periods can be anticipated.
• If wait times are unexpectedly long and you need to leave the clinic briefly, please let the front desk know. We may be able to reserve your place in line for a short period of time. If you leave without letting us know, we may have to remove you from the queue so that we may move on to assist the patients who are currently in the office waiting.

What Time Should I Come In?

During the school year (and flu-season in particular), patient volume can greatly increase. ReadyCare may reach capacity and therefor have to close the line for patients for the rest of the day.

This means coming in later in the afternoon can be risky!

• We understand that people’s schedules can vary, however at this time we often only have one physician working ReadyCare. There are only so many patients that they are able to see in a day while still being able to maintain efficient walk-in healthcare for our community.
• ReadyCare will continue taking patients into the later afternoon at the provider’s discretion.

ReadyCare closes on weekdays from 12:00pm – 1:00pm

• The provider will not see any patients during this time but you are still welcome to get in line and guarantee yourself a spot for the afternoon.

How Do I Know if ReadyCare Is Still Accepting Patients?

If you plan to come in the afternoon, it is recommend to give us a call before heading in to ensure we are still able to accept patients.

• While wait times can vary and change rapidly, we can generally provide you with a rough estimate of the current wait time if you give our clinic a call.
• Depending on the time of day, we cannot make any guarantee that we will still be accepting patients when you arrive. Closures are at the provider’s discretion and patient volume can sometimes be unpredictable. If you are traveling from out of town, it is recommend you come in the morning if you would like to ensure a spot in line.
• Signs are posted on the doors when the line is closed for the day.

What Should I Expect At My Visit?

Check-in at the front desk

• If you do not have your health insurance card, you will need to provide another form of proof of insurance. We likely will need your insurance ID number and the billing address for medical claims. Some plans we may be able to look up online, please call ahead of coming in to make sure you have all the necessary information.
• A photo ID is required to be seen. We accept a state ID or drivers license, a passport, or any other form of ID that has your name and photograph on it (such as a Cougar Card).

Identify your chief complaint/main health concern or issue

Please notify us immediately if you believe you are experiencing an emergency and we will have one of our clinic team members come out to assist you.

Complete brief paperwork for billing and registration purposes and collect copay

• Registration paperwork is required for all new patients. We also require it be completed once a year for billing purpose, and in the case of a name or address change.
• If you are unable to write for any reason, please let our front desk know and we will do our best to assist you.
• It is also at this time that we will collect any co-payment set by your insurance, if you are paying out-of-pocket for the visit we will collect that at the end of your appointment.

You are then placed in a waiting queue to be seen by the provider

Remember, ReadyCare is based on order of arrival and waiting times may vary. If you are concerned your issue is more urgent and/or unsure if ReadyCare is the right place for your issue, please let our staff know and we will have a clinical team member triage your symptoms to ensure that they are not better suited for another location.

Don’t forget to check-out

After your visit, stop at the check-out desk. If it is on the weekend, please stop back by the front desk.

• It is at this time where will we assist you with any referrals or orders that were placed by the physician as well as take any payment from those who are paying for their visit fully out-of-pocket.

About Billing & Insurance

Those With Health Insurance

ReadyCare is more affordable than the costs incurred at an Emergency Room or an Urgent Care. We accept and can bill most commercial insurances, but would require payment-at-the-time of service if we are unable to.

If you’re not sure if we accept your insurance or are looking for an estimation of benefits, it is recommended that you contact your insurance company directly. In most cases, the number for customer service is located on the back of your insurance card.

You may also contact our billing office at 509-332-1229 with any insurance or billing questions. If it is on the weekend, call the ReadyCare line at 509-332-8847 , as the front desk may be able to assist you.

Please remember that ReadyCare is a minor care clinic , and is not an urgent care facility. The billing and services provided by these two types of facilities are different.

Those With Medicaid Insurance

As of 2023, ReadyCare and Palouse Medical are contracted with Molina Apple Health of Washington , Coordinated Care of Washington , and some Idaho Medicaid plans (see disclaimers below). We are unable to accept any other out-of-state Medicaids. Unfortunately, Medicaid prohibits us from accepting payment for services from their members. This means if we are not contracted with your Medicaid plan, we are unable to see you at either ReadyCare or Palouse Medical.

If you have a state insurance plan that we are not contracted with, we recommended the following options:

• Call your primary care provider to see about scheduling an appointment
• Call your insurance company to see who is contracted closest to your location
• Seek emergency services

Disclaimers:

If you have Idaho Medicaid (and are not a current patient of Palouse Medical) please call and have us look into your insurance plan before heading in. We are not contracted with Idaho Medicaid Healthy Connections. If you have Healthy Connections, you will need to seek services in Idaho (such as Quick Care in Moscow), your primary care provider, or the emergency department.

If you have United Healthcare Apple Health and are a visitor or student, we may be able to see you in ReadyCare. If you have moved to Whitman County permanently and are still under this plan, it is recommended you call your insurance as soon as possible as this plan is no longer offered in our area.

Those With Medicare Advantage Plans

There are some Medicare Advantage plans that we are not contracted with. Depending on your plan, you may have to pay out-of-pocket for your services at ReadyCare. Please double-check with our billing office or the front desk before heading in to be seen.

Those Without Health Insurance

ReadyCare requires payment in-full at the time of service. We provide a 20% discount on the office visit to patients who are paying up-front.

Those Involved in a Motor-Vehicle Accident or Experiencing a Work-Related Injury

Motor-Vehicle Accidents

ReadyCare is unable to bill third-party insurances such as car insurance. Please know that if you are coming in to be seen for any injury pertaining to a motor-vehicle accident, you will need to pay for your visit in-full at the time of service. When doing so, keep your receipt as you may be eligible for reimbursement from the car insurance company.

Work-Related Injuries

ReadyCare is unable to bill a workman’s compensation claim for any patients that are not established with a provider at Palouse Medical.

• If you were injured at work and are not a Palouse Medical patient: Please reach out to your primary care provider for an appointment, or seek emergency services.
• If you are an established patient of Palouse Medical: Please call our billing office before coming in to ensure you have all the appropriate information needed for us to process your claim. In certain cases you may need to get a claim number from your employer before we are able to see you.

Unsure if you’re injury is work-related? Contact your employer! State laws provide you the right to receive workman’s compensation for injuries accrued while on the job.

For More Questions

If you have a concern about billing, insurance, or payments for services at ReadyCare, please call our billing office during Palouse Medical’s business hours (M-F from 8:00am-5:00pm) at 509-332-1229 .

If you are calling before 8:00am or on a Saturday, please feel free to check with the front desk by calling the ReadyCare line at 509-332-8847 .

DO NOT WAIT FOR CARE

If you are experiencing an emergency, dial 911 or seek care at a local emergency department.

How ER became ‘the big box retailer of healthcare’—and why it’s costing us all

Just as most people never forget their first kiss, I’ll never forget my first trip to an emergency room. I was twelve years old and excitedly looking forward to having what I was certain would be the summer of my life, touring and hiking national parks with other boys my age.

As it turned out, it was a miserable experience. After departing Philadelphia and being jammed for days in a station wagon with seven other kids and two adults, we arrived in the Grand Tetons, where I was overwhelmed by abdominal pain and flown to a Denver hospital for a potential appendectomy.

My parents quickly secured tickets and flew from Philadelphia to Denver to be there for the operation. I was brought into the hospital emergency room hours ahead of them, unaware of the cause of my omnipresent pain.

By the time my parents were reunited with me in the ER, my terror had morphed into red-faced humiliation. “Hey,” I said with a sheepish look on my face when they found me.

My parents turned to the doctor, who said, “Hello, Mr. and Mrs. Rosenbluth. Your son will be fine. He was just suffering from not moving his bowels for days, but it’s all good now. You’re free to take him home if you wish.”

Fast-forward to my freshman year at the University of Miami, when I was rushed off the football field with similar symptoms and taken to the emergency room at Doctors Hospital in Coral Gables, Florida. There, they found that my appendix had ruptured on the field and immediately operated, apparently saving my life. (Needless to say, my folks didn’t dare head to the airport for a repeat performance.)

These layered experiences of pain, fear, reassurance, and relief lay the groundwork for the emergency room (ER) of a hospital to become my go-to happy place as an adult. Whenever I experienced an inexplicable physical discomfort—headaches, stomach pains, mysterious backaches, dizziness, a racing heart—I could count on the ER being open 24/7 to save me from dying—or at least from worrying.

The feeling of being discharged with a nothingburger was always the best of all possible outcomes for me, even if, like most hypochondriacs, that sweet sense of relief lasted only until the next bout of anxiety. Of course, every time I use the services of a hospital ER for what turns out to be no reason, I’m costing myself—and every other healthcare consumer— unnecessary money. A lot of unnecessary money. And that’s a problem.

According to the most recent CDC statistics available, over 139.8 million Americans visit hospital emergency rooms each year. This translates to 42.7 visits for every 100 people. Of the people who are seen by an ER, only about 13 percent end up being admitted to hospitals. Not surprisingly, the ER visit rate for patients with private insurance was the lowest, while people who are on Medicaid or other state-based programs had the highest emergency room visit rate compared to other expected payment sources.

What do these numbers tell us? It’s tough to tease out how many people with health anxiety are driving up the number of ER visits, because there isn’t enough research available that reflects that number. But these statistics still reveal that a lot of people in the U.S. are going to the ER when they could be seen by a primary care doctor or an urgent care center provider instead—and that’s a real wallop to our healthcare system, both cost-wise and to the quality of care we can deliver.

One problem is that emergency rooms aren’t really set up to be “first come, first served,” so patients end up waiting longer. You might have a fever, but despite having already signed in with the triage nurse and waiting fifteen minutes, if a car accident victim comes in, you’ll be pushed down the line, and rightfully so. Wait times at urgent care clinics typically range from minutes to an hour, while patients in a busy ER can be sitting there two, three, or more than four hours, depending on who else shows up and what they’re presenting with.

There’s a domino effect that starts even sooner than that. Misuse or overuse of 911 calls for nonemergencies carries the risk of overwhelming emergency medical system services and threatens to increase ambulance wait time. This adds costs to municipal services. In addition, delayed EMS response time increases the risk to patients waiting for help.

As people stack up in the ER, wait times lengthen, contributing to overcrowding. This can negatively impact the quality of care. Prolonged wait times are directly associated with “higher risks of mortality, hospital admission, 30-day readmission, patient dissatisfaction, and costs,” according to one 2023 report in JAMA.

Another issue is cost. If you have insurance, you can typically get seen at an urgent care clinic for less than $150, which your insurance will cover if you’ve met your deductible. Your ER costs will always be much higher— maybe even six times as high—as what you would pay at an urgent care center. In fact, paying out-of-pocket for an urgent care appointment can be cheaper than your co-pay for an ER visit even if you have insurance, especially if an ambulance is involved. Plus, if too many people are trying to use the ER who shouldn’t be there, the overall cost skyrockets for everyone because of that pesky “supply and demand” truism.

The question of why so many people rush to the ER instead of waiting to see their primary care providers or going to an urgent care clinic is complex, but the underlying problem is usually a lack of access. For instance, some patients may seek out treatment in a hospital ER because they have no insurance or no primary care provider, and most emergency rooms won’t turn them away.

“People often have a logical reason for coming to the ER,” says Dr. Judd Hollander. This is true even for people who do have insurance, he added.

“Maybe they couldn’t get a doctor’s appointment in the near future and couldn’t find another way to get an evaluation,” he says. “Or maybe they couldn’t take time off work or find childcare during the day and had to see someone at night. But, let’s face it, people go to the ER a) when they have acute injuries, b) when their doctors are unavailable, or c) if they feel they need to be seen right away. Overall, I think the majority of patients who come to the ER are there because they’re uncertain about whether they do or don’t have a major problem.”

People also know they can get blood tests, imaging, or prescription medications through the ER right away, rather than having to wait for an appointment with their primary care provider or a specialist and have them order these things.

“The ER has become the big box retailer of healthcare,” Hollander says. “It’s the best one-stop healthcare shopping around.”

A recent study found that “in the United States, approximately 13% to 27% of ER visits can be addressed in ambulatory settings (including urgent care centers). Diverting these patients to the appropriate setting for care could decrease healthcare costs by $4.4 billion.” Slowing down the mad rush to emergency departments by people with low-acuity problems—or, as in my case, with health crises that are most likely in our own minds—is key if we’re going to stem the rising cost of healthcare. But how can we get more patients to get their complaints treated in more cost-effective settings, like urgent care centers?

We can learn something from Providence, Rhode Island, where an innovative, federally qualified health center facility called Providence Community Health Centers successfully executed a program to prevent avoidable ER visits. They freed up the EMS system to respond to true emergencies and life-threatening conditions by using their Mobile Health Unit to redirect nonemergency 911 callers to urgent care centers. During the twenty-six weeks of the Mobile Health Unit Diversion program under study, 8.4 out of every 10 patients who called 911 and were sent to an urgent care center were discharged home after treatment, avoiding a trip to the ER.

Easing the burden on our country’s emergency rooms could very well put us on the path to more effective, efficient patient care for everyone—including hypochondriacs. Accurate ER triage is essential if hospitals are going to devote their resources to providing top-quality care to the most critically ill patients. The most commonly used triage system in the U.S. is the Emergency Severity Index (ESI). This algorithm allows care providers to sort patients based on predicted acuity and resource needs. For instance, Level 1 patients need immediate care, Levels 2 or 3 need care within fifteen minutes, and Levels 4 or 5 require care within thirty minutes.

Currently, mis-triage (inappropriate care) happens nearly a third of the time—often when the emergency room is backed up or short-staffed. Not surprisingly, this occurs most often in poorer neighborhoods, where emergency rooms are more crowded, people are less likely to have private insurance, and many more patients crowd into the ER during nights and weekends.

Triage clinicians are often pressed for time. When that happens, they must make assignments with limited information, because there’s no time to truly get to know the patients’ histories.

Now let’s throw patients with illness anxiety disorder into the mix. When patients with medically unexplained physical symptoms (MUPS) arrive in the ER, clinicians are often stumped. This happens a lot, because MUPS patients comprise up to a third of all those seen in hospital outpatient clinics. In one landmark study of medical outpatients in North America with new complaints of common symptoms like chest pain, dizziness, and headaches, only 16 percent of the cases were found to have an organic cause.

This “somatization” of physical symptoms without any organic explanation is a manifestation of psychological distress—but feels all too real to the person experiencing it. Understandably, most physicians are trained to look for something physically wrong. Meanwhile, there’s a growing tendency in emergency medicine toward quickly ruling out the big, scary conditions such as ischemic heart disease, pulmonary embolism, and deep vein thrombosis, among others. Patients who would otherwise wait several weeks for outpatient stress tests can complete assessments in the ER within hours. But this kind of testing is extremely costly.

Unfortunately, frequent flyers through the healthcare system might go to the ER again and again to ease uncertainties about this or that pain, and because they rarely see the same providers there, they continue to get testing and referrals to specialists. One solution to this is to ensure that historical records of past ER visits are readily available whenever these cases show up, and to have senior staff confer with junior staff about how to manage patients with chronic somatization by sending them to a primary care provider.

From the book Hypochondria: What’s Behind the Hidden Costs of Healthcare in America by Hal Rosenbluth and Marnie Hall. Copyright © 2024 by Hal Rosenbluth and Marnie Hall. Reprinted by permission of Rodin Books. Available June 18, 2024.

Hal Rosenbluth is CEO of New Ocean Health Solutions.

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June 4, 2024 | Kim Krieger - UConn Communications

Emergency Room Visits for Self-Harm Skyrocket

Between 2011 and 2020, an increase of nearly 19%

(Tina Encarnacion/UConn Health photo)

The number of emergency visits to hospitals in the US for suicide attempts increased markedly between 2011 and 2020, a University of Connecticut researcher reports in the June 4 issue of the American Journal of Psychiatry . The rise emphasizes the country’s enormous unmet need for mental health services.

The number of lives lost to suicide in the US has climbed alarmingly over the past decade, with close to a half-million between 2011 and 2022, according to the federal Centers for Disease Control and Prevention (CDC). Suicide rates have risen by 35% since 2000. The rate of self-harm has risen too, even in age groups not previously considered at risk, such as children.

Out of all visits to the emergency department in 2011, only 0.6% involved self-harm. That number had risen to 2.1% of all emergency department visits by 2020, according to data from the National Hospital Ambulatory Medical Care Survey, a yearly sampling of hospitals across the nation by the CDC. The data was analyzed by UConn School of Medicine psychiatric epidemiologist Greg Rhee and colleagues from the Mayo Clinic, Columbia University, Yale University School of Medicine, and the Veterans Administration Connecticut Healthcare System. The figures per 100,000 people increased from 261 per 100,000 in 2011 to 871 in 2020.

“When we translate the data to percent change, it is an 18.8% increase, which is huge,” Rhee says. Their most striking increase was in self-harm visits for adults over 65, which went up by 30% annually. But every age group saw double digits annual increases, including children ages 5 to 11.

The increase in suicide and suicide attempts has already been noticed by the US government, which introduced a new crisis phone number two years ago, 988, at which people can access crisis counseling and get referrals to further resources. But other recent analyses by Rhee and his colleagues have shown that there are still high barriers to mental health care.

“Intentional self-harm is preventable. We can potentially reduce suicide or suicide-related events. There are multiple ways. A lot of individuals undergoing mental distress could be taken care of so that they don’t harm themselves,” Rhee says.

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