What an ER visit actually costs
Billed at levels 1 through 5, and billing a routine visit at a high level is the most common emergency room error.
List price
$3,227
What the hospital lists the procedure at.
Cash price
$1,131
What the hospital charges someone paying without insurance.
Cash is
35%
of the list price. The self-pay discount, as published.
What different people pay
| The list priceWhat the hospital publishes as its gross charge | $3,227 |
| Paying without insuranceThe hospital's own discounted cash price | $1,131 |
| An insurer with a contractMedian of the rates hospitals publish per payer and plan | $1,033 |
| MedicareFacility plus the doctor's fee, whole visit | $2,765 |
The gap is the argument
A list price is close to fiction. Almost nobody pays it: Medicare does not, no insurer with a contract does, and the hospital itself will take far less from someone paying cash. It is an opening number.
If your bill for emergency room visit is near the list price, the figures above are what you raise. Ask for the cash price by name, it is published and they are required to honour it. Then ask why you are being charged more than a contracted payer for identical work.
What these numbers are not: a quote. Prices vary by hospital, by region and by what else happens during the visit. These are medians of what hospitals published, not an average of what people were billed.
Emergency care is the one thing you cannot shop for, which is exactly why these bills run high and why so many of them are wrong. Almost every ER bill has room in it.
You got an ER billWhere this came from
Prices published by 57 hospitals in their machine-readable files under 45 CFR 180.50, 175 of which listed a cash price for this procedure. Those hospitals are all part of one health system, so treat these as that system's published prices rather than a national average. Retrieved 2026-08-07. Medicare figures from the Centers for Medicare & Medicaid Services.