What is the average cost of a hospital ER visit? According to the Medical Expenditure Panel Survey (MEPS), the average cost of an ER visit was $1,150 in 2020, up 6.3% from 2019. (If you add medical inflation to 2022, the ER cost estimate would be about $1,210.) Adults ages 18 to 64 had the highest average visit cost at $1,385. Infants and children under age 18 cost $821 per visit on average. Age 65+ averaged $849. The average ER visit cost for someone uninsured was about $1,500 in 2020, up 23% compared to a year earlier. Someone under age 65 with private insurance had an average ER visit expense of $1,682. Many people made more than one trip to the Emergency Room in 2020. Consequently, the total expenditure per person with one or more ER visits during the year, was $1,724 in 2020. The median expenditure per person with an expense was $852.
The costs reported by MEPS are the expenditures (total amounts paid by all parties including insurance) for the ER visits. Actual charges would be much higher. An older, but detailed explanation – using cost to charge ratios – was published in December 2020 (HCUP Statistical Brief #268). It reports an average cost (different methodology) for an Emergency Department visit in 2017 of only $530 (which would be about $609 in 2022 dollars). The federal government has not released costs for the 2021 Emergency Department visits yet. The interactive tool may be difficult for many people to use.
Emergency Medical Services page at MedlinePlus includes multiple reports by the American College of Emergency Physicians, on topics such as Emergency Room (ER) costs, tips for seniors, children and when to use the emergency department, as opposed to going to urgent care.
Should you go to the Emergency Room (ER), or to an urgent care center? Useful overview, by a private for-profit company GoHealth Urgent Care.
A list of accredited Geriatric Emergency Departments in hospital ERs. Accreditation is provided by ACEP Geriatrics, the American College of Emergency Physicians. Click on Geriatric ED Accredited List. Unfortunately, it is not user-friendly as an Excel file. The first tab GED Accreditation will provide the basic information about who is meets accreditation standards, city and state, accreditation level. Gold (1) is the highest level. Date the organization was accredited is given. Read about the standards for optimal emergency care for older adults. When last checked, April 22, 2022, just 306 EDs in the US met some level of the geriatric ED accreditation standards. Updated 2022.
In October 2022, the American Academy of Pediatrics, the American College of Emergency Physicians and the Emergency Nurses Association agreed on recommendations to promote pediatric patient safety in the Emergency Department / ER. Topics include leadership, patient safety culture, communication and handoff failures, errors in diagnosis, staff burnout and managerial factors such as reporting near-misses and close calls. “Optimizing Pediatric Patient Safety in the Emergency Care Setting” was published in the AAP Journal Pediatrics, Nov. 2022. Free full text.
Find hospital trauma programs that are Verified Trauma Centers by ACS. Level I, II and III Trauma Centers are listed here, by city or state (and other international locations), at the American College of Surgeons’ (ACS) website. Trauma Center designation is a voluntary process that hospitals may choose to pursue for Adult and/or Pediatric care. Level I is the highest level of five levels. A description of what’s expected to be available at each level can be found at the American Trauma Society.
What is the truth about ER visit waiting time? CDC’s 2019 National Hospital Ambulatory Medical Care Survey reveals the median waiting time to see a physician or other provider in the Emergency Department was 14 minutes (see Table 4), a minute shorter than the previous year. Sixteen percent waited an hour or more. The average calculated wait time was 37.4 minutes. In 2019, most patients (55%) spent between one and four hours in the Emergency Room). About 56% arrived outside of the M-F 8a to 5p hours. More than half (57%) of ER patients were triaged as semiurgent or urgent when they arrived. (However, when billed at discharge or admitted to the hospital, the overwhelming majority of ER visits are likely to be billed as at least a moderate to high severity. Data not shown in this report.) Percent admitted or transferred to another hospital (including observation stays): 16.3%. Main reasons for an ER visit: stomach and abdominal pain, cramps or spasms; chest pain and fever. Cough, shortness of breath and headaches also were common. Of the 44 million injury-related (or poisoning or adverse effects) visits, 26% were for falls – more than double the rate of motor vehicle traffic-related injuries seen in Emergency Rooms. 2020 and 2021 ER information not yet available as of September 2022. Click on NHAMCS Emergency Department Summary Tables.
When should you go to Urgent Care instead of the ER? Here’s what one health system suggests for using a clinic Urgent Care setting vs. a hospital Emergency Room. Example is from Scripps in California. Updated September 2022.
Find accredited healthcare facilities in all states, by The Joint Commission (TJC). TJC is formerly JCAHO – Joint Commission on Accreditation of Healthcare Organizations. It accredits hospitals and other healthcare organizations. Quality Check provides accreditation and comparison information for hospitals, behavioral health care, home health/hospice, laboratories, some nursing homes (called nursing care centers) & assisted living centers, and other health care services. A few actual scores for acute care hospitals, emergency departments and behavioral health (mental health) programs may be available for 2021. For nursing homes, consumers are advised also to check state inspection reports . In the past, we have discovered a 1-star Florida nursing home (the lowest possible rating in the state) had been accredited by the Joint Commission. Consumers are always advised to check multiple sources and ratings when researching quality of care. Conflicts in scores may suggest quality is not consistent. Updated 2022.
Find the number of injuries from ATVs – All-Terrain Vehicles and other Off-Highway Vehicles (OHVs). The Consumer Product Safety Commission has issued its annual report of injuries and deaths from ATVs. Injuries brought an 112,300 people to the ER in 2020. More than 30,000 injuries were to kids under age 16, representing 27% of all OHV-Related Emergency Department-Treated Injuries in 2020. ER treated injuries associated with off-road vehicles were up 17% in 2020 (the first year of the pandemic), compared to 2019. Nearly one in five was hospitalized. The most common body parts for injury were head & neck, and arm. In 2018, there were 681 deaths associated with ATVs and other OHVs. Report released November 2021.
Arkansas hospital volumes, prices, quality ratings and patient satisfaction are listed by name of hospital. Find average charges (a proxy for average costs) for 40 common hospitalizations at specific AR hospitals by Clicking on INPATIENT PRICING after you’ve selected your hospital. Price List varies by hospital, but may include maternity and childbirth, stroke, chest pain, stomach disorders, back pain, nutritional problems (diabetes), blood infection (septicemia), rehabilitation, heart attack, cardiac cath, drug coated stent, congestive heart failure, kidney failure, urinary infection, COPD, pneumonia, total hip or knee replacement surgery, hysterectomy, psychiatric care, ventilator support and more. Volumes are listed under the hospital’s Profile. To find quality scores on emergency department, heart attack, heart failure, pneumonia, COPD, stroke, delivery or surgical infections, and patient opinions, click on QUALITY at each hospital’s page. Hospital Consumer Assist is provided by the Arkansas Hospital Association. Prices from 2017; Quality and Patient Satisfaction scores reflect 2018 ratings. Information is outdated. No updates were made during 2020, 2021, or 2022. Medical inflation has been at least 15% since 2017.
Find out the average charge and average amounts allowed (cost) for an office visit, ER visit, outpatient tests and hospital stays in Colorado. More than 60 types of hospitalizations and almost 90 outpatient types are listed. Web site shows average price and amount paid in 2020 for each major insurance company. Compare the 9 regions such as Denver, Boulder, Ft. Collins, East CO, etc. Average cost for a 15-minute office visit (code 99213) was $101 in CO in 2020, compared to an average charge of $199. A new patient visit (99203) cost $176 for 30 minutes; the average charge was $288. The most common type of ER (emergency room department) visit cost $1,293 (allowed) compared to $2,432 in charges. The ER visit code was 99283. The next two most common ER visit types cost $2,202 and $3,586 on average; their charges averaged almost $4,800 and $6,600 respectively. Most likely there were additional tests and imaging charges that were added to the bill.
Almost 13,000 Medicare Advantage cataract and lens procedures were done in 2020 (code 66984). While the average cataract removal charge was over $4,400, the allowed amount was $1,053. The Medicare member was responsible to pay $105 to $227, depending on insurance company. For other insurance, the member might have to pay $943 for a cataract removal. View prices and average costs for colonoscopy and ambulatory knee arthroscopy surgery. Inpatient costs include maternity and newborn charges, C-Section delivery, psychiatric admission, alcohol treatment, rehab, depression, diabetes and many more hospital stays. Consumers may wish to add medical inflation of at least 4.4% for 2022. Provided by the State of Colorado.
Find average prices for an Emergency Department visit in Florida in this report. Summary report shows average cost (charges) in 2018 for a hospital ER visit based on acuity. Low acuity Pediatric visit for under age 10 cost about $1,100 in 2018. The more common high acuity pediatric ER visit (through age 17) had an average cost of $3,655, up almost 7% from the prior year. For adults, a high acuity average 2018 charge was $8,164. Common symptoms average cost shown, e.g. $10,506 adults for abdominal pain visit to the ER; $6,215 for back pain; $5,167 for a sprain; $5,450 for a superficial injury/contusion; $2,772 for upper respiratory infection visit; $5,287 for adult pregnancy complication; adult urinary tract infection averaged $7,598. Average pediatric visit for upper respiratory infection cost $2,114. Self-pay uninsured average charge was $1,201 for a low acuity visit, to $6,736 for high acuity. Medical inflation has been more than 13% since 2018, and should be considered in estimating 2023 prices. 26 pages, published by FL Agency for Health Care Admin. This is the latest available report as of July 2023, and it appears Florida has no plans to update the Emergency Department reports.
Florida ER visit charges for each hospital in 2019. Find the average cost of an emergency room (ER / ED) visit at each Florida hospital in 2019. State average ER visit cost (charge) was $7,321 (about $68 Billion for over 9.2 million ED visits). Average cost was up about 10.8% from 2018. HCA Fawcett Memorial Hospital in Port Charlotte had the highest average charge in FL again in 2019, at a whopping $17,330 per ER visit in 2019. Their average price went up 12.6%. Three additional hospitals had average charges over $16,000: HCA Mercy Hospital a campus of Plantation General Hospital, HCA North Florida Regional Medical Center in Gainesville, and HCA Regional Medical Center Bayonet Point – the same as in 2018. All of the most expensive (average charges) for ED visits are for-profit hospitals. Only 4 hospitals in Florida had an average charge of $1,500 or less. The least cost was Madison County Memorial Hospital in Madison, with an average ER visit cost of just under $1,200. Number of ER patient visits are shown here. The highest volume Emergency Department was Lakeland Regional Medical Center, with 172,000 visits. Its average price was $7,815. They are not-for-profit. Complexity and seriousness of the visit vary from hospital to hospital. Easy to use tool, but not severity-adjusted. Average charges for broad diagnostic groups can be found, by using the filters in the search tool. From FloridaHealthFinder.gov. Check our listing for Hospital Compare to see each hospital’s most recent star ratings and performance on emergency care. The site defaults to 2018 costs, so make sure you check the 2019 box to see the latest. No updates as of March 2023 for 2020, 2021 or 2022 costs of an ER visit. Medical price inflation has gone up about 10.4% since 2019.
Find Georgia health insurance plan ratings and comparisons for 2023. Scroll to the bottom to find External Quality Review Organization (EQRO) which lets consumers read about performance of health plans in GA. Large report using HEDIS measures. Compare quality ratings and member satisfaction scores for Medicaid, Amerigroup, including 360 (Anthem); CareSource, Peach State Health Plan, and GA Families Statewide. Covers asthma care, cancer screening, immunizations, dental visits, ER visits, diabetes care, heart care, prenatal care, 7-day followup after mental health admission, member satisfaction (CAHPS) and more using 2021-2022 performance scores. Other reports are at this website that may have more information. Released in April 2023 by Georgia Dept. of Community Health at dch.georgia.gov
An average physician office visit in 2021 cost $365, compared to $1,164 for an Emergency Room visit. Average expenses went up 9% last year for a physician office visit, and are $100 higher than five years ago. Costs for an ER visit were up 1.2% over last year, and about $160 more than five years ago. Consumers should expect higher costs for 2023 and 2024; $365 in 2021 is about $381 in 2023 using medical inflation factors. With inflation, $1,164 is about $1,215 in 2023 dollars.
MEDIAN expenditure per PERSON with an expense was $513 for office visits and $834 for ER visits. The median expenditures cover the total for the year, including multiple visits. The data from MEPS (Medical Expenditure Panel Survey) informs consumers about the large difference between cost of care in a doctor’s office vs. Emergency Dept, more than 3 times higher. The main link for ER cost and office visit is to the interactive database.
Separately, the most recent MEPS Statistical Brief #517 analyzed Expenses for Office-Based Physician Visits by Specialty and Insurance Type, 2016. published in October 2018. It is mentioned here only for reference because it shows primary care visit cost $186 in 2016; pediatrics office visit cost $169; ophthalmology visit $307 and OB-GYN visit $280 (all 2016 dollars).
Louisiana Hospital Ratings and Prices from lahospitalinform.org. The most recent quality ratings and outpatient charges (prices) at this site are from 2020. Consumers could add minimum 5.3% medical inflation to translate to 2022 dollars. No dates on the number of inpatients and inpatient charges. Compare 3 hospitals at a time, side by side. Average costs are not shown; only range of charges (low price and high price only) for Medicare patients. Also compare hospitals on number of cases at LA hospitals. Find hip or knee surgery price range, gall bladder removal, psychiatric admission, rehab, heart problems, stent, stomach problems, stroke, GI hemorrhage, kidney failure, COPD, pneumonia, diabetes, bowel surgery, more. Outpatient Medicare prices include heart tests such as cardiac cath, heart imaging, pacemaker; CAT scan or CT angiography; GI endoscopy, mental health, general surgery, chest x-ray, MRI, more. Because it’s Medicare patients only, childbirth delivery, C-section and newborn average costs are not included. Quality tab shows volumes for each procedure and scores from Hospital Compare (federal government site). LA Hospital Inform is sponsored by the Louisiana Hospital Association.
Massachusetts Hospital Association website presents each hospital’s unit-by-unit staffing plans budgeted for 2022, by shift, and actual staffing for fiscal year 2022 (and prior years). First in the country to voluntarily post nurse-to-patient staffing ratios. May be difficult for consumers to interpret to compare MA hospital performance, especially with all the different types of inpatient units. The Emergency Department information includes average daily number of ER visits. Massachusetts PatientCareLink; click on Staffing Plans and Reports.
Compare Nevada hospital ratings, ER care, and patient satisfaction scores. NV hospital performance ratings on Emergency care, mortality for Heart care, pneumonia, stroke, and COPD; infections, adverse events (mistakes), plus patient opinion ratings. Shows 2020-2021 data. Click on the green “ABOUT” button on each measure to see the data collection dates for each measure. Some measures may be the same as at CMS Hospital Compare website, but dates may vary. Consumers may view 3 or more hospitals side-by-side. When updated December 2022, the Patient Satisfaction ratings were not always working properly. Nevada Hospital Association website.
Compare Nevada hospital ER visit prices (2021) for common reasons people visit emergency departments. Choose illness and hospital (one hospital at a time). Compare to common charges in the county and NV average. For example, a migraine treated in ER typically cost $7,141 in NV. (Note, the median charge went up 20% per year since 2014, for migraines treated in the ER.) Consumers should also note that physician fees are extra, and NOT shown in the website prices. They may also need to add inflation factors. Prices are disease-specific. Nevada PricePoint through NV Hospital Association.
Compare New Hampshire prices for physician office visits, Emergency Room, psychotherapy, dental care, hospital outpatient lab tests, PT visits and some surgery. Ambulance and medium level ER prices are included in NH. Prices are estimated at 2021-2022 prices plus 5% price inflation. Statewide cost estimate is also shown. (Example is $286 average cost for an office visit 99214. But for the uninsured, costs after discounts in a few towns could be below $100.) Choose Medical or Dental. The average dental cleaning for an adult cost $122. The average cost for a comprehensive dental exam in New Hampshire is estimated at $120. Select insurance, or uninsured to compare charges with your deductible. “Show All Procedures” will let you select procedure, test (e.g. lab, Radiology such as x-ray, MRI, CT or ultrasound), office visit or service. Tonsillectomy, gall bladder surgery, hernia repair, colonoscopy and a few other surgeries are bundled to include surgeon and anesthesia costs. Price transparency project developed by the New Hampshire Insurance Department. NH HealthCost is an excellent website, easy to navigate. It is more current than most, and has earned Editor’s Pick.
The Guide to Texas HMO Quality 2020-2021 shows detailed clinical quality comparisons of HMO health insurance plans. Compare HMOs Aetna, Christus, Cigna, Community First, FIRSTCARE, HMO Blue Texas, Humana Health Plan, Memorial Hermann, Scott and White, and United Healthcare of Texas. Indicators include asthma, childhood immunizations, cancer screening, heart care, high blood pressure, diabetes care, prenatal care, behavioral health, mental illness care and followup, opioid prescriptions, flu shots, antibiotic utilization rates, rates of physician board certification, and more. Lengthy (226 pages) but valuable report. Published by TX Office of Public Insurance Council. No updates as of October 2022.
Find Virginia Healthcare Prices for ER visits, ambulatory surgery, tests and hospital stays. This site shows average price ALLOWED (commercial insurance prices) in 2018 for almost 40 common healthcare services in VA. Includes a mix of outpatient, clinic, hospital stays and other services such as an ambulance (median $550) or an emergency helicopter ride ($19,466 which includes average base cost of $14,402 plus mileage). Examples: hospitalizations (maternity), outpatient xray/imaging, CT and MRI tests; colonoscopy, mammogram; inpatient or ambulatory surgery (e.g. hernia, gall bladder, knee replacement, tonsillectomy, kidney stones); and ER or well-child visits (median $126). Shows median and range of costs and provides a breakout by type of cost: facility, surgeon, anesthesiologist, etc. Also shows average price by setting: clinic vs. hospital vs. ambulatory surgical center; and region of Virginia. The median amount allowed for an ER visit (medium, code 99283) was $1,091. The 2020 report shows allowed amounts for each service that you or your insurance plan ACTUALLY PAID in 2018. More relevant than most pricing information, but lags in timeliness. Add at least 12% medical inflation rate to estimate 2022 costs. Virginia Healthcare Pricing Transparency, from Virginia Health Information (VHI), updated June 2020. No new updates as of August, 2022.
Find 2022 ER visit prices to WI hospital emergency departments (ER). Shows median (middle) price for ER (2022) WITHOUT the physician’s fee. It also shows how many cases the hospital treated. Must know how complex the visit is, or use the CPT code. The most common is “high level” of medical decision-making (CPT 99285). Statewide, hospitals charged $2,150 (median charge during 2022) for ER visit 99285. While the tool is slow and cumbersome, Wisconsin Hospital Association’s PricePoint makes comparing hospital prices possible. This site is one of the more up to date sites for healthcare price transparency. Compare hospitals downtown vs. those in the suburbs. Updated 2023. Urgent care prices do not appear to be included any longer, nor are 50 services within Emergency Department visits. Sample median cost for two levels of ER visits:
|Hospital median ER visit Facility charge in 2022||CPT Code 99285 (High)
$ charge (median)
|CPT Code 99284 (Moderate)
|Statewide median hospital ER visit charge||$ 2,150 (93,967 visits statewide)
||$ 1,486 (30,593 visits statewide)
|Aurora St. Luke’s (Milwaukee)||3,050||1,990|
|Children’s Hospital (Milwaukee)||1,443 (median age 3)||1,098 (median age 5)|
|Unity Point Meriter (Madison)||3,283||2,286|
|St. Mary’s (Madison)||2,457||1,602|