How Much Does an ER Visit Cost?

How much does an ER Visit cost? The short answer is a lot. A single ER visit cost $1,150 on average in 2020. Emergency Room visits by those who were uninsured cost almost $1,500 on average. Visits by people under 65 who had private commercial insurance had an average cost of $1,682.

The picture might actually be a little more expensive than you think. People who make one ER visit, may easily have another ER visit or two in the same year. Including such multiple visits, the average cost for people visiting the Emergency Room in 2020 was $1,724. The median “typical” cost was $852 per person. If you bring those costs forward to 2022, by adding annual medical inflation, consumers should expect an average cost over $1,800 and a median cost close to $900. The average out of pocket cost was $526 plus or minus about $214.

Some groups have a higher average cost. For example, those who were uninsured and used the Emergency Department one or more times in 2020 had an average cost of $2,188. People ages 45 to 64 had an average expense of $2,243. Average costs for people ages 18 to 44 were also high, at $1,935. That’s a big hit to your budget.

You might be interested to know that the higher your income, the more likely it was that a bigger bill occurred. The average expense for a high-income person’s ER visit was $1,526, compared to around $800 for people in the lowest two (poor) categories. Remember, this is “base cost” only, without counting the extra tests that are required based on your condition.

There were 68 ER visits 
for every 100 babies under age 1
in 2020

How likely is it that you’ll have a trip to the Emergency Department? Perhaps more likely than you think. CDC reported that 10% of kids under age 5 had at least one ER visit in 2020. Although this rate was down during the first year of the COVID-19 pandemic, amazingly, there were still 68 ER visits for every 100 babies under age 1. Overall, 11% of people had an ER visit in 2020. Many people avoided visiting hospitals the year the pandemic started. The rate was closer to 14% in 2019. The highest ER use rate was by people aged 65-plus (17%). By ethnicity, Native Americans and Blacks were somewhat more likely to visit an ER in 2020 than other groups. By income level, poor people were at least 60% more likely than high income people to visit the ER in 2020.

In Vermont and 6 other states,
you can compare hospital ER visit costs
side-by-side

Vermont is one of the few states that publicly reports the base price for an ER visit. With just fourteen hospitals in the state, consumers can see on one page, how hospital Emergency Departments compare on price. The basic 2022 hospital charge averaged $433 for a non-urgent lowest Level 1 visit, ranging up to $2,097 for the highest severity Level 5. This price covers only the base charge for the facility and doctor. If you need a lab test, an x-ray, an MRI, some fluids, something sewn up, or a major life-saving effort, that’s extra. Add the cost of each extra procedure to the base price. Nationally, three-fourths of ER visits resulted in at least a blood test, an x ray, CT or other imaging test, a urinalysis, an EKG, an IV, or some kind of test (2020 data).[1] It is very easy and quick to generate a bill well into the thousands of dollars.

How Much are Copays for ER visits?

Copays for Emergency Care vary according to your insurance plan. In 2023, my HMO plan, for example, requires a $110 copay. That’s up from $90 last year. It’s not uncommon to see health insurance plans with a $500 copay cost for an ER visit. A quick check on the federal Health Insurance Exchange[2] today, revealed some pretty expensive possibilities for out-of-pocket costs. If you have a Bronze plan, with high deductibles and low monthly premiums, an ER visit might be subject to the deductible. Many of the Bronze plans in my area said “No charge after the deductible”. The deductible might be $9,100 in 2023. So that means one would pay the full cost (charges minus the insurance discount) up to $9,100. Another plan said an ER visit would cost “$500 copayment with deductible”, which was $9,050. I guess that must mean it could cost $9,550. A third plan option was the “Deductible and 20% coinsurance”. If the total charges came to $15,000 after discounts, and the person had a $9,000 deductible, the total expense comes to $10,000. Wow. What does your health insurance plan require for Emergency Care copays or deductibles?

Maybe you are thinking, those kinds of high numbers couldn’t possibly be true. However, take Nevada. According to the latest data[3], the average charge for emergency department (ED) visits, including everything, was $11,214. The busiest ED, Sunrise Hospital in Las Vegas, had an average charge of more than $12,000. The most expensive hospital, St. Rose Dominican Siena Campus in Henderson, had an average charge of almost $18,000. The least expensive, Banner Churchill Community Hospital in Fallon, had an average charge of $2,302 last summer. Of course, a trauma center hospital will have more seriously injured patients, and thus more services on the bill.

Nonetheless, better check your insurance plan ahead of time. It’s smart to compare your potential out-of-pocket costs for the ER with any alternatives you might have if your condition is not too severe. Maybe you have just a $50 copay for urgent care, and possibly no copay at all for a primary care doctor visit. See your doctor now, and maybe you could avoid an ER visit later.

Last Word

Facing a potential bill into the thousands of dollars, you only want to use the ER if you need that level of help and urgency. An Urgent Care Center might be a lower cost option. And yet, the best alternative may be to call your doctor’s office to see a provider who has an open appointment slot. The average physician office visit cost in 2020 was $335. For a kid under 5, the doctor’s office visit cost was $231. Your wallet will thank you.

 

[1] https://www.cdc.gov/nchs/data/nhamcs/web_tables/2020-nhamcs-ed-web-tables-508.pdf

[2] https://consumerhealthratings.com/?healthcare_entry=find-health-insurance-plans-and-prices-on-the-marketplace-exchange-healthcare-gov

[3] Nevada hospital charges for third quarter, 2022, available at https://consumerhealthratings.com/?healthcare_entry=nevada-hospital-inpatient-er-visit-ambulatory-surgery-average-charages