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Average Cost for People with Hospital ER Visit, MEPS Editor's Pick

Average expenses for people who had one or more visits to the Emergency Room (ER) were $1533 in 2014, up 7.7% from 2013 according to the Medical Expenditure Panel Survey (MEPS). Median, or typical, cost was $749. For people ages 45 to 64, the cost was substantially higher on average ($2176, up 18%). Uninsured people under age 65 averaged $1251 in expenses ($585 median), of which they paid more than 1/3 out of pocket. While average cost for those age 65 and up was generally $1300-1400, Medicare recipients paid only 3 to 6% out of pocket. Median charges for children under age 18 were $449 to $544. In a separate report (not shown), the average expenditure PER Emergency Room visit for 2016 was reported at $1004, compared to $265 for a physician office visit. Many ER users end up having more than one trip to the Emergency department, so the expenses can add up in a year. The federal government has not prepared a detailed report for the 2016 data, yet. It may have discontinued detailed explanations, in favor of the online interactive tool – which we think would be very unfortunate.

California – Average Inpatient and Outpatient Hospital Prices, 2018

Find prices for CA hospitals including Kaiser and Shriners. Inpatient prices are listed in the complicated Charge Master, which shows the charge for every pill, lab test and hospital room rate. MRI and CT tests should be included. More useful are the outpatient files (look for Common25 in the filename), which list the average cost (charge) for top 25 types of outpatient procedures or surgery with CPT code). Hospital Outpatient reports may show prices for Emergency Dept. ER visits, lab tests, CT, MRI, Mammo, x-ray, ultrasound, PT visit, Arthroscopy, colonoscopy, hernia repair, gall bladder removal, etc., depending on their highest volume. Files are in Excel file format. Prices are from June 2018. Consumers can see one hospital at a time.  Provided through California OSHPD.

Emergency Dept. Report – Florida 2015 data (pdf)

Summary report shows average cost (charges) for a hospital ER visit based on acuity. Low acuity Pediatric visit was about $900 in 2015; high acuity pediatric ER visit was about $2800. A For adult women, low acuity mean charge was $1785; High acuity average 2015 charge for men was $6673. Common symptoms (e.g.$2012 for upper respiratory infection visit; $9167 adults for abdominal pain visit to the ER; $3791 for a sprain; $5906 for adult headache including migraine, adult urinary tract infection averaged $6258 and more.) Average cost increased with age. See Tables 4 and 5 for average prices for an emergency visit and Insurance status or Self-Pay charges. 28 pages, published by FL Agency for Health Care Admin. Nov. 2016. No updates as of early 2019.

Florida ER Visit Charges, 2017 (interactive)

Find the average cost of an emergency room (ER / ED) visit at each Florida hospital in 2017. State average ER visit cost (charge) was $6136 (about $55 Billion for nearly 9 million ED visits). North Florida Regional Medical Center in Gainesville had the highest average charge in FL at a whopping $15,136 per ER visit in 2017. Only 1 hospital (Regional General Hospital Williston) had an average charge of $1000 or less. Volume of patients shown here. The highest volume Emergency Department was Lakeland Regional Medical Center, with nearly 170,000 visits. Its average price was $6457.  Complexity and seriousness of the visit vary from hospital to hospital. Easy to use tool, but not diagnosis-specific. From FloridaHealthFinder.gov.  Check our listing for Hospital Compare to see their most recent star ratings and performance on emergency care.

Healthcare Expenses for Seniors (MEPS)

Healthcare expenses for seniors are outlined in this MEPS report on Health Care Expenditures for the Elderly Age 65 and over. Median annual expenditures were $4,206 per person. Average annual expenses for those with expense were $9,863 in 2011. Using medical inflation rates, $9,863 was about $12,194 in 2019 dollars. Medicare paid over 62% (up considerably from 10 years earlier); private insurance paid 16%; out-of-pocket amount declined to 12%. 96% of seniors had some healthcare expense, most often office-based care and prescribed medicines. Medications took up 22% of the total, averaging $76 per purchase. For seniors, the inpatient room rate averaged $3,199 per day (sticker shock, and nearly $4,000 in 2019 dollars); ER visit was $884 on average; office visit was $228. MEPS Statistical Brief #429 uses 2011 data, published Jan. 2014.

How Much Does an Office Visit cost compared to an ER visit?

An average physician office visit in 2008 cost $199, compared to $922 for an Emergency Room visit (median was $89 for doctor’s visit, vs. $422 for ER). Top 5 conditions shown for each ambulatory care visit type. Consumers should expect considerably higher prices since 2008; $922 in 2008 is about $1244 in 2019 using medical inflation factors. However, this report informs consumers about the drastic difference between price of care in a doctor’s office vs. Emergency Dept. MEPS data published in Statistical Brief #318, March 2011

Nevada Hospital Inpatient, ER and Ambulatory Surgery 2018 Average Charges

NevadaCompareCare.net shows average charges (prices) for every NV hospital DRG (Diagnosis Related Group), and average ER or ambulatory surgery charge in 2018. Overall Nevada inpatient charge was a whopping $81,368 per stay, or more than $15,000 per day. Sample DRGs: Psychoses (average $17,304), Normal Newborn ($4,654), uncomplicated vaginal delivery ($21,933), Septicemia (about $110,000 with complications, $57k without), Major joint replacement (hip or knee) at $113,000, Cesarean Section ($38,000 without complications, $46,000 with). Births overall (all types including very ill babies) averaged $27,580 in charges, from $2,170 at Banner Churchill to $68,049 at Sunrise Hospital and Medical Center. Average NV emergency room visit charge was $8,757 statewide for over 1 million visits. ER charges ranged from $1,651 average at Mount Grant General Hospital, to $12,758 average at St. Rose Dominican – San Martin Campus. Statewide average Ambulatory Surgery Center charge was $8,534, but no breakout by procedure type. Outpatient surgery at a hospital averaged nearly $33,000 in charges. Standard Reports also show case volume by facility. No information about how much was actually paid. NV reports are a joint effort between Center for Health Information Analysis (CHIA) and the Division of Health Care Financing and Policy (DHCFP). Updated May 2019

Vermont – Compare Hospital ER Prices (2019) Editor's Pick

Compare published prices for hospital Emergency Room visits, for all 14 hospitals in VT, according to level of severity and complexity.  Statewide average ER price is $341 for Level 1 minor problem, before adding tests or procedures. Very few visits are this “simple”. Level 2 low severity ER visit average price is $501 before adding test costs.  Level 3 moderate severity and complexity ER visit (the most common in the US)  average price is $843 for hospital and physician charges, excluding tests and medications etc. Level 4 average price is $1292. Top base price for a Level 5 visit is $1830 per visit ($1275 hospital, $555 doctor fee). For consumer planning purposes, billing code Levels 3, 4 and 5 are most likely to occur.  A recent study of Medicare patients found that the most common ER visit charge was for a Level 5 visit, right at the top of the complexity scale. Both facility and physician charges are shown – an amazing show of leadership in price transparency. Springfield Hospital’s Level 5 charge is $1215; the University of Vermont Medical Center’s Level 5 ER charge is just shy of $3000. Prices do NOT include lab tests, imaging tests or procedures during the ER visit. Prices are good from October 2018 to September 2019.  Table 3D.

Virginia Healthcare Prices – Ambulatory Surgery, Tests, Hospital Stays

Virginia Healthcare Prices shows average price ALLOWED (commercial insurance prices) in 2017 for almost 40 common healthcare services in VA. Includes a mix of outpatient, clinic, hospital stays and other services such as an ambulance (average $522) or helicopter ride (almost $17,000). 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 office visits. 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 Virgina. Median physician office visit cost was $77.  The 2019 report shows the average allowed amount for each service that you or your insurance plan ACTUALLY PAID in 2017. More relevant than most pricing information, but lags in timeliness. Add at least 4.1% medical inflation rate to estimate 2019 costs. Virginia Healthcare Pricing Transparency, from Virginia Health Information (VHI), updated May 2019

Wisconsin ER and Hospital Urgent Care Prices (Emergency Department) Editor's Pick

Find ER visit and urgent care prices for common visits to WI emergency departments (ER) or hospital-based urgent care. Examples of typical charges: mood disorders, urinary tract infection (UTI), nausea and vomiting or teeth problems. Shows median (middle) price for ER (2018-2019) WITHOUT the physician’s fee, and how many cases the hospital treated. If the hospital has on-site urgent care, it will show that price also. Example: Mercy Health Hospital in Janesville charged $2,102 (median charge during April 2018 to March 2019) in the ER for urinary tract infection (UTI), but just $345 in its urgent care service. Free-standing community Urgent Care clinics are not included in these prices.  Wisconsin Hospital Association’s PricePoint makes comparing hospital prices possible. Compare hospitals downtown vs. those in the suburbs.

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