ER savings guide

ER Savings Guide

An ER visit involves three things you can prepare for: wait time, the visit itself, and follow-up care.

A higher ER cost does not mean better care. To compare quality, use the CMS hospital overall rating shown in the comparison tables. Cost differences usually reflect negotiating power between insurers and hospitals, a hospital's own financial position, or the leverage physicians and nurses hold in their contracts.

Time cost

How long you wait depends on symptoms, staffing, and the ER's current load.

Visit cost

The visit can split into facility, clinician, testing, imaging, and insurance costs.

Post-ER follow-up cost

Follow-up appointments for labs, imaging, specialists, or surgery can add up fast.

Know what to expect

What happens before, during, and after.

Time cost

The ER triages by risk, not arrival order.

Some symptoms move faster through triage. Less urgent visits depend heavily on the ER's current load.

What to know

Chest pain, stroke symptoms, severe breathing trouble, or major bleeding may be seen faster.
Ambulance arrivals and patients already inside the ER can change the wait even when the lobby looks quiet.

How to save time

Use the city guides to compare local ER wait time and historical wait time.

Visit cost

One ER visit can turn into multiple bills.

An ER visit usually produces at least two bills: a hospital facility bill and an ER physician or professional bill.

What to know

The ER physician bill is usually paid line by line, based on CPT codes.
The hospital facility bill is more complicated.
- Commercial insurers may pay hospitals in different ways: line by line, one bundled amount for the ER visit, a percentage of billed charges, a per-day rate, or another contract formula. If the patient is admitted to the hospital, the payment may be bundled into the inpatient stay instead of treated as a separate ER visit.
- Medicare usually pays outpatient ER hospital services using formula-based rates, and if the patient is admitted to the hospital, the hospital stay is usually paid as one bundled amount for the inpatient stay.
- Medicaid, CHIP, and state programs vary by state.

How to save money

For self-pay care, check ER cash prices at hospitals in your city.
Avoid unnecessary treatments in the Emergency Department to reduce your cost.
Use FAIR Health or Bill Sherlock to check if your ER bill is reasonable.
Use Dollar For to apply for hospital financial assistance at no cost.

Post-ER follow-up cost

Shop services and protect yourself from price gouging.

After an ER visit, you may need follow-up care like lab work, imaging, specialist visits, or procedures. Each one comes with its own set of bills.

How to save money

Imaging: an independent imaging center is often much cheaper than a hospital or hospital-owned imaging center, even with insurance. If using insurance, confirm it is in network.
Labs: Labcorp or Quest are much cheaper than doing labs at the hospital, even with insurance.
Surgery: for scheduled follow-up care, ask for the billing CPT code and a good faith estimate.
- Even if you have insurance, you can choose not to use it for that care and ask for a self-pay good faith estimate.
- If the quote is high, ask the surgeon, "Do you do this same operation at any other facility?" Surgeons often work at multiple hospitals or ambulatory centers. Call the facility and get a quote.
- For inpatient surgery (staying in the hospital over 24 hours), check your insurance policy on inpatient services and whether prior authorization is required. If you decide to use insurance and it requires prior authorization, make sure your doctor's office has gotten it approved before the procedure. Not all offices stay on top of this.

ER Level 4 Cash Price by Metro

Compare average cash prices for a level 4 emergency-room visit across supported metro areas.

We use ER level 4 because it is generally the more commonly used ER visit level now, especially in commercial claims. Bars show metro average cash-price midpoints from synced hospital price transparency records.

Metro areaAverage level 4 cash pricePrice

Orlando

13 ER locations

7 ER locations have cash price data

$6,843

San Jose

8 ER locations

5 ER locations have cash price data

$4,817

Tampa Bay

28 ER locations

24 ER locations have cash price data

$4,174

Richmond

9 ER locations

8 ER locations have cash price data

$3,869

San Francisco Bay Area

36 ER locations

28 ER locations have cash price data

$3,844

Sacramento

15 ER locations

12 ER locations have cash price data

$3,743

San Diego

14 ER locations

10 ER locations have cash price data

$3,706

Jacksonville

13 ER locations

8 ER locations have cash price data

$3,022

Kansas City

30 ER locations

7 ER locations have cash price data

$2,910

Miami

49 ER locations

27 ER locations have cash price data

$2,830

San Antonio

16 ER locations

11 ER locations have cash price data

$2,601

Columbus

18 ER locations

15 ER locations have cash price data

$2,106

Houston

82 ER locations

75 ER locations have cash price data

$2,093

Salt Lake City

11 ER locations

11 ER locations have cash price data

$2,045

Boston

41 ER locations

31 ER locations have cash price data

$1,964

Austin

21 ER locations

18 ER locations have cash price data

$1,959

Riverside-San Bernardino

34 ER locations

18 ER locations have cash price data

$1,934

Los Angeles

68 ER locations

34 ER locations have cash price data

$1,918

New York City

116 ER locations

69 ER locations have cash price data

$1,872

Cincinnati

21 ER locations

6 ER locations have cash price data

$1,845

Dallas-Fort Worth

90 ER locations

81 ER locations have cash price data

$1,755

St. Louis

33 ER locations

8 ER locations have cash price data

$1,683

Chicago

83 ER locations

52 ER locations have cash price data

$1,561

Philadelphia

44 ER locations

32 ER locations have cash price data

$1,471

Providence

14 ER locations

13 ER locations have cash price data

$1,444

Seattle

28 ER locations

25 ER locations have cash price data

$1,438

Charlotte

19 ER locations

9 ER locations have cash price data

$1,342

Phoenix

37 ER locations

19 ER locations have cash price data

$1,303

Washington, DC

37 ER locations

33 ER locations have cash price data

$1,258

Portland

16 ER locations

9 ER locations have cash price data

$1,233

Raleigh

4 ER locations

1 ER location has cash price data

$1,213

Virginia Beach

12 ER locations

8 ER locations have cash price data

$1,181

Cleveland

20 ER locations

9 ER locations have cash price data

$1,150

Atlanta

29 ER locations

18 ER locations have cash price data

$993

Pittsburgh

29 ER locations

19 ER locations have cash price data

$827

Baltimore

19 ER locations

13 ER locations have cash price data

$627

Denver

22 ER locations