ER cost methodology
How ERcost.com compares ER visit cost data
ERcost.com uses hospital price transparency records to compare published ER visit price data by metro area and facility. These records are source data points, not quotes, insurance estimates, or guarantees of a final bill.
ER visit levels and CPT codes
Emergency department evaluation and management visits are published as levels 1 through 5, mapped to CPT codes 99281–99285. Higher levels reflect more complex visits. ERcost matches hospital transparency data to these standard codes when comparing facilities.
| CPT code | Level | Description |
|---|---|---|
| 99281 | Level 1 | Usually a very limited emergency department service. The services are provided by ancillary staff rather than the same physician or qualified health professional structure used for higher ED visit levels. |
| 99282 | Level 2 | Straightforward medical decision making: a minimal problem, no tests or records analyzed, and negligible risk from the management options considered. |
| 99283 | Level 3 | Low medical decision making: low-complexity problems such as multiple minor issues, a stable chronic problem, or a straightforward acute illness or injury, with limited data review and below-average management risk. |
| 99284 | Level 4 | Moderate medical decision making: a worsening chronic problem, multiple stable chronic problems, an undiagnosed higher-risk new problem, unexpected acute symptoms, or a complex injury, with moderate data workup and average management risk. |
| 99285 | Level 5 | High medical decision making: a severe chronic problem or an acute or chronic problem or injury that may threaten life or bodily function, with extensive data review and above-average management risk such as hospitalization or urgent high-risk treatment decisions. |
Why ERcost defaults to level 4
ERcost shows level 4 pricing by default because it is one of the most commonly billed ER visit levels. A Health Affairs analysis of ED spending from 2012 to 2019 found that higher-intensity visit codes now represent a large share of billed visits, with level 4 as the single most common level by 2019. Users can switch to any level when comparing facilities. The actual level assigned to a visit depends on the care documented, but most ER visits fall under levels 3, 4, and 5.
What an ER bill can include
After an ER visit, patients typically receive multiple separate bills from different providers, not one combined total. ERcost focuses on the facility-level ER visit charge because it appears on every facility bill. Patients will see it as a line item on their itemized statement from the ER facility.
Other bills may arrive separately from:
- The emergency physician group (physician, PA, or NP)
- The lab or pathology provider
- The radiology group (X-ray, CT, ultrasound reads)
- The pharmacy or infusion provider (medications, IV fluids)
- An ambulance transport company
- Specialists consulted during the visit
What patients should keep in mind
The prices shown on ERcost are published data points from hospital transparency files, not personalized estimates. Insured patients may pay a different amount depending on their plan, network status, deductible, and copay or coinsurance terms. Uninsured or self-pay patients should ask about financial assistance programs, which many hospitals are required to offer. Use ERcost as a starting point for comparison, not as a prediction of a final bill.
Data freshness
ERcost refreshes its ER visit cost data at least annually. Hospitals may update their files at different intervals, so freshness varies by facility.
Why some facilities show unavailable
Hospital machine-readable files vary in format and completeness. ERcost only displays a value when it can match a facility and ER visit level with enough confidence to label the source, version, and freshness.