Cost Comparison: Emergency Rooms vs. Urgent Care Centers
Emergency rooms provide excellent care, but you can wait eons if you have a non-life-threatening problem and still pay through the nose. Understandably, ERs serve patients based on the severity of the problem and charge for access to their wide-ranging facilities.
The wait at urgent care centers, on the other hand, can be minimal, and the cost for services often runs one-fourth of what you'll pay at a hospital or one-half for a visit to your doctor.
Sometimes called a "doc in a box," these freestanding walk-in centers usually offer extended hours. Staffed by physicians, nurses, and fully-trained assistants, urgent care centers provide solid, basic care for non-life-threatening medical situations. Most can perform basic X-rays and lab work and dispense prescriptions.
Another difference between an ER and an urgent-care center is availability. ERs are required to provide 24-hour emergency care, whereas privately funded urgent care centers have the right to establish set hours.
If you experience symptoms of a heart attack or stroke, or feel your "life or limb" is in danger, go directly to an ER or call 911 and do not pass go. According to the American College of Emergency Physicians (ACEP), you should visit the ER if you have any of the following warning signs:
- Chest pain or pressure
- Uncontrolled bleeding
- Sudden or severe pain
- Coughing or vomiting blood
- Difficulty breathing or shortness of breath
- Sudden dizziness, weakness, or changes in vision
- Severe or persistent vomiting or diarrhea
- Changes in mental status, such as confusion
- Heavy bleeding
- Large open wounds
- Sudden change in vision
- Chest pain
- Sudden weakness
- Trouble breathing
- Major burns
- Spinal injuries
- Severe head injury
- Loss of consciousness
- Abdominal pain
The ACEP recommends you visit an urgent care center for:
- Sprains
- Strains
- Minor broken bones
- Mild asthma attacks
- Minor infections
- Small cuts
- Sore throats
- Rashes
- Minor burns
- Urinary tract infections
- Pelvic infections
We researched cost comparisons for the nine most common reasons people visit the ER. Estimates do not include medications or other follow-up services. The cost estimates were determined by calculating the average allowed amount on claims submitted for the Medica Choice Network. All costs represent a single visit.
1. Allergies
The average urgent care center charges $97 for allergy-related problems, whereas ERs standardly charge $345.
2. Bronchitis (Acute)
Urgent care average pricing is $127, while ER charges average $595.
3. Earache
This common childhood ailment will run $110 at an urgent care center and $400 at an ER.
4. Sore Throat
Visit an urgent care center for a sore throat, and your average bill will be $94; at an ER, the average tab comes to $525.
5. Pink Eye
Irritating, but not life threatening, Pink Eye runs $102 at urgent care and $370 at an ER.
6. Sinusitis
This inflammation of the sinuses can result in an infection, so it should be treated if the problem persists. Urgent care will charge $112 and ERs $617.
7. Strep Throat
"Streptococcal pharyngitis" usually appears suddenly with severe sore throat pain. It can be particularly frightening for children, is highly contagious, and requires immediate treatment, but an urgent care center will charge just $111 for a visit and an ER $531.
8. Upper Respiratory Infections
It's particularly important that those with asthma or emphysema deal with upper respiratory infections before they turn into pneumonia. Urgent care will charge $111, with the average ER bill coming to $486. If you're experiencing severe difficulties breathing, however, check with an urgent care center to ascertain if you should go directly to an ER for treatment.
9. Urinary Tract Infections
Experts recommend you see a doctor as soon as you experience urinary tract infection symptoms. Treatment at urgent care will run $110, as opposed to $665 for a visit to the ER.
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I've never been to an urgent care center. Are they treated by insurance as ERs or as Dr. visits? My copay for a doc is only $15 but a visit to the ER is always $50. Any idea which this would fall under? I have previously had to go to the ER when I got or discovered an infection on a Friday and my regular doc couldn't see me. It was never life threatening but bad enough to make me scared to wait until Monday. I would love to use an urgent care center if it would save time and $.
Insurance plans will differ on how urgent care visits are covered. You should check your plan summary and/or call your insurance company and ask.
My insurance considers an urgent care visit as a Dr. office visit with the corresponding lower co-pay than an ER visit. As a former hospital employee, I highly recommend urgent care centers for situations where you are ill and need to see a doctor, but don't have time to wait to get in to see your doctor. However, if you think your life might be on the line, then the ER is best. The last time I went to the urgent care was to get X-rays on my foot and I was in and out within an hour and had my X-ray read before I even left. There is no way that I would have gotten such quick service at an ER.
DON'T GO!! I just opened a bill today, July 15, 2013 for an Urgent Care walk in back in May when I had a 4 day low grade fever and couldn't lie down w/out having fits of coughing. I am covered by insurance but the visit was in Houston and that's out of my Aetna network. The bill for a chest ex-ray and peeing in a plastic cup --- not PLATINUM -- was a grand total of $3,72.60!! Talk about "Elite Care"! My insurance company paid them $686 and says I owe the rest. According to this article, the average cost in an Urgent care facility for what I had done should have been $221. I'm stunned.........and thinking about digging up Marvin Zindler to go help me fight it! ;0) If you go in ANY medical facility, get the pricing UP FRONT and in writing! And, good luck w/that.
Jayne your Urgent Care bill was expensive because of the imaging services- I work in an ER and can say with certainty that it would have been exponentially more expensive at an ER.
Yeah...no comparison in terms of cost. I love our Urgent Care! They are usually open weekends and late on weekdays, which is usually when my body likes to get sick.
I have only been to the ER once in my life, and I really thought I was dying, so there was no way around it (turns out it was a very bad allergic reaction, but no big deal).
I have never spent more than an hour at an Urgent Care from walk-in to walk-out.
@Tracey - Our insurance has a special line item for urgent care (I think it's a $50 copay). Our ER copay is like $200, so I'm guessing if you do have one, it would be something like $25?
We have a fairly good insurance plan but we are on a no-deductible PPO plan where we don't have an annual deductible as long as we stay with in network providers. That's normally not a problem but a glaring omission is that there aren't urgent care facilities on the list. So, our alternative in this case is to either wait until our doctor opens or go to the ER, which as you pointed out is much more expensive. I know one time on different insurance I went to urgent care when I had a nasty poison ivy rash at a time where the doctor wasn't able to see me for a couple of days, and it was considerably cheaper than had I gone to the ER for what would have amounted to the same treatment.
So, for those with insurance I'd make sure that your plan covers urgent care if you decide to go this route.
One problem with urgent care (at least the one here) is they charge $100 upfront, while ERs can never do that. That puts urgent care out of the reach of many uninsured, even if they'd be more able to pay the bill later.
Also, wait times in urgent aren't always better than hospitals. ER waiting lines are worse when urgent care is closed (because everyone who would have been at urgent care is at the ER), but when it's open it's the luck of the draw which one would have been quicker. It varies a lot. My quickest wait was halloween in the ER. I guess everyone was at a party or taking their kids trick or treating, because there was no one in the waiting room and they took me right back and it was test test diagnoses prescription discharge just back to back and I was out in no time. Of course not everyone likes that. My friend had a very similar experience in the same hospital, but instead of being happy she was out the door she was mad because she thought they didn't take the time to listen to her. Not everything is best for everyone.
As an RN having worked in both ER and Urgent Care, your article is well written. Urgent Cares were created to help take some of the burden off the ERs, since aprox. 90% of the pts. seen there do not have life threatening emergencies. Despite the growing number of Urgent Cares, our ER's are busier than ever with people that could have taken care of their problems with their own MD's, drug seekers, those with no insurance and those with no comprhension of our medical system. Their wait times are up more than ever. In our city it took my daughter 4 hours to be seen with a kidney stone; there were too many chest pains that kept coming in and were bumped ahead of her, understandable, but didn't help with her pain.
Urgent Cares can have long waits also. Try to come at times that are not so busy for faster care. Don't come right at 5PM and expect to be seen right away, and don't come 5 minutes before they close. You might get through faster, but won't get as good care by the tired staff. And please don't come in for refills on narcotics, you're wasting your time and everyone else's. An Urgent Care is not the replacement for your own personal health practioneer and common sense.
If you truly need to go to an ER, please go there instead of trying to save money by going to an Urgent Care. It will end up costing you more because you not only pay for Urgent Care but an ambulance trip and the ER.
Otherwise, an Urgent Care can save you a lot of time and money taking care of minor health problems that arise when you can't wait to get in to see your MD for minor injuries and illnesses, if you're out of town, etc.
This may apply to some of the other common ailments above. I called my doctor's office after hours about a UTI and, because I've had them before knew that's what it was, the nurse staffing the after hours phone called in a prescription for me - no need to see a doctor.
When I was a kid I remember my mom doing the same for earaches (my brother had them frequently) and maybe when I had strep. This may depend on your medical history and your relationship with your doctor. I'm not sure if the middle path (going to the lab for a sample/culture ordered by the after hours nurse without seeing a doctor at UC or ER) is possible, but if it it that would also avoid the office visit copay.
This may apply to some of the other common ailments above. I called my doctor's office after hours about a UTI and, because I've had them before knew that's what it was, the nurse staffing the after hours phone called in a prescription for me - no need to see a doctor.
When I was a kid I remember my mom doing the same for earaches (my brother had them frequently) and maybe when I had strep. This may depend on your medical history and your relationship with your doctor. I'm not sure if the middle path (going to the lab for a sample/culture ordered by the after hours nurse without seeing a doctor at UC or ER) is possible, but if it it that would also avoid the office visit copay.
This may apply to some of the other common ailments above. I called my doctor's office after hours about a UTI and, because I've had them before knew that's what it was, the nurse staffing the after hours phone called in a prescription for me - no need to see a doctor.
When I was a kid I remember my mom doing the same for earaches (my brother had them frequently) and maybe when I had strep. This may depend on your medical history and your relationship with your doctor. I'm not sure if the middle path (going to the lab for a sample/culture ordered by the after hours nurse without seeing a doctor at UC or ER) is possible, but if it it that would also avoid the office visit copay.
This may apply to some of the other common ailments above. I called my doctor's office after hours about a UTI and, because I've had them before knew that's what it was, the nurse staffing the after hours phone called in a prescription for me - no need to see a doctor.
When I was a kid I remember my mom doing the same for earaches (my brother had them frequently) and maybe when I had strep. This may depend on your medical history and your relationship with your doctor. I'm not sure if the middle path (going to the lab for a sample/culture ordered by the after hours nurse without seeing a doctor at UC or ER) is possible, but if it it that would also avoid the office visit copay.
Aw shoot, sorry about the multiple posts!
Whether urgent care is cheaper than the ER depends on your insurance. My previous insurance changed the same copay for urgent care or the ER.
I've only gone to urgent care once, for strep throat that developed late on a Friday evening. With my doctor not open on the weekends I was stuck either waiting until Monday or paying for the urgent care. I went to urgent care first thing Saturday morning. I waited about 20 minutes (apparently I wasn't quite first thing enough). The employee who did my initial throat culture said it came back negative for strep but the PA (or possibly nurse practioner, I don't remember) wasn't convinced (I had all the signs of strep, including the nasty white things in the back of my throat) so she gave me a prescription for the meds and I was one my way. It was much more expensive than my regular doctor and I don't feel that the care was as good (I did feel like I was just being moved along a conveyor belt), but the final outcome was good and it was better than suffering through the weekend.
If you life is not in danger, regardless of co-pay rate you should go to UC. Will you get faster service?...maybe. At least your insurer will not have to pay the ridiculous ER rates. Why do think health coverage cost's soo much? If we all tried to save the insurance companies money, it may bring the cost of insurance down some Plus... If we all used UC in place of ER's, those with life treating conditions will have a better chance of survival.
I agree Totally with you! Read my post. Some of the hospitals are calling their triage area a separate name and they are charging the same ridiculous ER prices! I don't usually go to the ER because I never have had a life threatening condition but when you are in agony that doubles you over and causes you to cry, the walk in is not an option for me. Usually when I go to these places, I have the experience where they give you a pill, tap you on the head, and send you out the door! It is very frustrating! Then you have to wait to get into you preferred provider, while you are still in pain and then they can't figure it out and then they send you to someone else, and etc. etc. etc. It is exhausting. Gone are the days if you had different issues going on your doctor treated you for everything. Now, you have to go to a certain MD if you are having a nose bleed etc. etc. Exaggeration but you know where I am going with this!
Make sure that your Urgent Care center follows the Urgent Care pricing model. Our local Urgent Care considers themselves to officially be part of the E.R. (which is about 5 miles away), so they bill the same way, even though they call themselves Urgent Care.
They say that even though the Trauma Center E.R. is 5 miles away, because it is part of the same organization, going to the urgEnt caRe give you all the same benefits, so no decrease in costs.
The local newspaper did a huge investigation into this a few months back.
yes, I had a major acute pain issue this last week. I had gone to my regular MD to find out if it was a UTI, since it wasn't, they told me to get some Prilosec since I had been on additional pain meds. from a specialist doing working with my chronic pain issues. ANYWAY, as the pain got worse over the weekend, I refused to see the ER. Could have went to the walk in but they usually tap you on the head, give you a pill and send you on the way, at least that was my experience in the past! FInallY I called the ER nurse consultant. told them 3 times i wasn't wanting an ER visit due to $$. They said that had something called ER Express and that it was like an urgent care, since it was Sunday, my husband and I went in. Turned out it was an ER triage. When I finally complained to a higher up on Monday, they said that they were sorry and there is nothing they can really do with the bill. I am very angry and am warning people to make sure there special terminology is not the actual ER. I have insurance but am still going to have to pay...can't imagine those paying out of pocket! I am still in agony now with nausea and the works! My hubby says I am not aggressive enough in the doctors to figure this out! So now he wants me to go to urgent care...again a pill and send me back to my regular uncooperative provider. Viscious cirlce!
I LOVE urgent cares- it has totally revolutionized my family's health care. For example, when I was on vacation I developed an eye problem. With no local physician my only option would have been an emergency room where non-emergent conditions wait 2-6 hrs to see someone and demand $100 cash up front, even though I have insurance. I went to a local urgent care, got my eye taken care of right down to a prescription in my hand in under 45 minutes with no out of pocket expense. I was later billed a whopping $20. And no more getting sick on the weekend and missing school or work for a doctor appointment because urgent cares are open Saturdays and in many places Suindays too. What a great money saver these places have been to us!
Don't rely on the costs estimate in this article if you use the SOMC Urgent Care Facility in Wheelersburg, Ohio. My wife had a routine bladder infection visit to that facility and the charges (routine) were over $600.00.
Same exact thing happened to me.
I have a long history of UTI's so I knew just what I had but I had just moved to the area so no pcp yet. Went to urgent care, peed in a cup, saw the NP and was out of there in 45 min.
Got a bill for Lab and Urgent Care for $600. Just yesterday I got a bill from the doctor at the urgent care!!!! So I got charged $250 just to be in the Urgent Care and then billed seperately for the doctor telling me I had white blood cells in my specimen.
Total for 45 min visit: $991. My insurance covered minimal and I have to pay approx $600 of it.
I am livid.
The hospital nearest me charges $2,800 just to walk into the ER. If you have a cut finger they will charge about $100 per stitch. If you don't have insurance you don't go to the ER unless you know you will die otherwise, or unless you're an illegal immigrant, then it's free.
I don't know where you got your information but you need to do your research again. One visit to the emergy care center, not the hospital, costs $1400.00 for a simple super glue finger bandage. They said they were in line with the hospital. I think that is ridiculous for twenty minutes in at the most.
Pieper
I have been to 2 different urgent care centers multiple times each and they are both filled with incompitent "doctors". I will never go there again. It's a waste of money, you get what you pay for.
I went to an urgent care facility. I knew what was wrong and what treatment I needed. I had a chest cold, have athsma and when I get a chest cold all I need is an inhaler to keep my bronchial ways open. Walked in, explained the problem, saw a nurse practitioner, she authorized a nebulator treatment, gave me a prescription for an inhaler. I was there LESS than an hour all together, 20 minutes of which were with the front desk filling out insurance info, ten minutes waiting to see the NP, ten minutes using the nebulizer, another ten waiting for them to come back to the treatment room and the last ten getting the presription and leaving. Cost? $495.00! This is the most outrageous abuse of bill padding I have ever seen. WILL NEVER GO AGAIN, they are rip offs. No wonder America can't afford health care, it is licensed stealing!
I think your article has very good points, and I appreciate your taking the time to do the research on costs and report it as well. Family members and myself have tried both ER and the urgent care centers for various things. However, I must add that if it's something in any way unusual, you may be better off going to the ER, because while those at the urgent care centers are very kind and have the best of intentions, some things are beyond their knowledge or resources. Thus, misdiagnoses and not-quite-right treatment for the ailment are more likely to occur, as has happened in our case. If you do have the luxury of weighing the pros and cons before deciding which place to go, please do.
I need help on this I went to an urgent care for an emergency I had a fever over 100 goin in I was reassured I was covered, they had me come back 5 times to make sure I was feeling better. I found out 3 months later they were charging my insurance 25k. My insurance is inly covering 2% because they are out of network. Why do place like this exist and why is my insurance doing nothing about this?