Emergency vs Urgent Care Costs

By HealthPriceCompare - June 19, 2023

The cost differences between emergency care and urgent care can vary depending on several factors, including the specific healthcare provider, location, and the nature of the medical condition. Emergency care tends to be significantly more expensive than urgent care due to the higher level of resources, equipment, and specialized staff available in an emergency department. Here are some general guidelines to assist you when making the decision between emergency and urgent care:

Emergency Care

Emergency rooms (ERs) are equipped to handle life-threatening conditions and severe injuries that require immediate medical attention. The cost of emergency care can be significantly higher due to the 24/7 availability of specialized medical staff, advanced diagnostic equipment, and the ability to perform complex procedures. However, it's important to note that costs can vary widely depending on the severity of the condition and the treatments provided.

When you get registered as a patient at the ER, you are charged a triage fee, typically $250-$1000. When you get assigned to a room, you will incur a facility charge that is typically around $1,000 to cover your time in the room and the nurse's time. One misunderstood aspect of emergency rooms is that physician and professional fees are not included within the facility charge and often get billed separately, along with any medications or medical supplies received during your visit.

On average, moderate to severe emergency room visits range from $1,500 to $3,000 but these costs can also depend on the patient's insurance status. Patients enrolled in Medicare, for example, would be responsible for a copayment for each services plus 20% coinsurance of the approved amount for doctor visits after meeting their Part B deductible. This is typically far less than the full amount that patients in high-deductible health plans must pay.

Urgent Care

Urgent care centers provide immediate medical care for non-life-threatening conditions that require prompt attention but are not severe enough to warrant an emergency room visit. The cost of urgent care is typically lower than emergency care because urgent care centers have fewer overhead costs compared to hospitals. They often provide a wide range of services, including treatment for minor injuries, illnesses, diagnostic tests and X-rays.

The average cost of an urgent care visit can be anywhere between $100 to $200 depending on your insurance coverage and the type of services you receive. If you are covered by a traditional health insurance plan, the visit may be covered in full but if you are in a high-deductible health plan or don't have insurance, you will likely be responsible for the full amount. Keep in mind that an urgent care visit is often a fraction of what an emergency room visit would cost.

This Can Be Attributed to Several Factors

Level of Resources: Emergency departments are equipped to handle life-threatening conditions and have a higher level of resources available, such as specialized medical staff, advanced diagnostic equipment, and operating rooms. These resources come at a higher cost, including staffing expenses, maintenance of equipment, and the availability of round-the-clock services.

Overhead Costs: Emergency departments are part of larger hospitals, which have higher overhead costs compared to standalone urgent care centers. Hospitals have larger facilities, more staff, and additional services to manage, which contribute to higher overall expenses. Urgent care centers are typically smaller and have fewer overhead costs.

Complexity of Cases: Emergency departments handle a wide range of complex and severe medical conditions, including trauma, heart attacks, strokes, and other life-threatening emergencies. Treating these critical cases requires highly trained medical professionals, specialized equipment, and the ability to perform complex procedures, all of which add to the cost.

Availability and Accessibility: Emergency departments are open 24/7 and are designed to provide immediate care at any time, including nights, weekends, and holidays. This constant availability requires additional staffing and resources, which increases the cost. Urgent care centers often have more limited hours and may not provide the same level of availability as emergency departments.