How much does a level 5 (most severe) emergency room visit cost in the US?

Across 1,223 hospitals that publish federally required price files, the median negotiated rate is $712, and the middle half of hospitals fall between $574 and $1,130. Self-pay cash prices have a median of $1,160 across the 996 hospitals that list one. What you pay out of pocket depends on your deductible, coinsurance and network.

Why do ER Visit (Level 5) prices vary so much?

Each hospital negotiates separately with each insurer. In these files the priciest tenth of hospitals negotiated more than 5.3 times what the cheapest tenth did, and state medians run from $535 in Mississippi to $3,174 in Utah.

Is the cash price cheaper than using insurance?

Sometimes. At 312 of the 996 hospitals that list a cash price (31%), it is lower than that hospital's own median negotiated rate. If you have a high deductible, ask the hospital for its self-pay price before you book.

What is the Medicare rate shown here?

$608 is the CMS national outpatient (OPPS) payment rate for this service (July 2026). We show it as a government baseline: the national median negotiated rate is 1.2 times it.

All procedures / ER Visit (Level 5)

ER Visit (Level 5) Cost in the US (2026): What 1,223 Hospitals NegotiatedNPI VERIFIED

Across 1,223 US hospitals that publish federally required price files, the median negotiated rate for a level 5 (most severe) emergency room visit is $712 — 1.2× the Medicare outpatient rate of $608. The middle half of hospitals negotiated between $574 and $1,130; the priciest tenth negotiated more than $1,976, 5.3× the cheapest tenth (under $376). Hospitals that list a self-pay price ask a median of $1,160 (996 hospitals).

Code CPT 99285 · Source: hospital machine-readable files (45 CFR §180), file dates 2022-11-12 to 2026-09-28 (median 2026-04-01) · Medicare baseline: CMS OPPS Addendum B, July 2026 · Data extracted 2026-10-06 · Page updated 2026-10-07

National median

$712

all plan types · 1,223 hospitals

Middle half

$574–$1,130

25th–75th percentile of hospitals

Median cash price

$1,160

self-pay · 996 hospitals list one

Medicare baseline

$608

CMS OPPS national · July 2026

1,223 hospitals, one bar per price band

median $712Medicare $608

$0$2,500$5,000

Each bar counts hospitals whose median rate falls in that price band; the last, dashed bar holds the 11 at $5,000 or more. The cheapest tenth negotiated under $376, the priciest tenth over $1,976 — 5.3× apart for the same procedure.

These are contract reference rates, not your bill. A median across hospitals is not a quote for your plan or network. Your out-of-pocket cost depends on your deductible, coinsurance and network status.

This is the hospital's facility fee for the visit level only. Tests, imaging, medication and the emergency physician's own fee are billed separately.

Coverage: 1,223 of the 5,419 hospitals in the CMS roster have an identity-verified price file with this procedure in our data. It is not a random sample, and a hospital missing here has not been judged non-compliant — we may simply not have its file yet. 96 of these 1,223 hospital files were more than 12 months old at extraction — hospitals must update yearly; we keep the figures and say so rather than hide them.

By insurance type

Insurance type	Hospitals	Median	Middle half	× Medicare
Commercial (plan type not stated)	703	$1,350	$847 – $2,096	2.2×
PPO	727	$1,527	$910 – $2,404	2.5×
HMO	494	$1,352	$832 – $2,239	2.2×
EPO	115	$1,620	$1,090 – $3,278	2.7×
POS	65	$1,717	$1,335 – $3,312	2.8×
ACA Marketplace	461	$1,022	$787 – $1,359	1.7×
Medicare Advantage	732	$594	$499 – $670	1.0×
Medicare (as listed)	693	$609	$561 – $684	1.0×
Medicaid	744	$558	$293 – $861	0.9×
Federal employees (FEP)	22	$3,547	$2,740 – $3,919	5.8×
Workers' comp	129	$1,083	$744 – $1,750	1.8×

Plan types are grouped from each hospital's plan names. Each figure is a median of hospital-level medians; types with fewer than 20 hospitals are left out.

By state

State	Hospitals	Median	Middle half	× Medicare	Median cash
Alabama	17	$539	$488 – $556	0.9×	$643
Arizona	12	$664	$629 – $689	1.1×	$1,462
Arkansas	15	$554	$448 – $597	0.9×	$1,244
California	40	$802	$762 – $946	1.3×	$1,950
Colorado	8	$685	$596 – $1,138	1.1×	$1,719
Florida	50	$664	$655 – $1,089	1.1×	$1,577
Georgia	32	$667	$593 – $1,057	1.1×	$705
Hawaii	9	$1,058	$607 – $2,237	1.7×	$2,261
Idaho	14	$950	$525 – $1,894	1.6×	$1,306
Illinois	48	$908	$638 – $1,371	1.5×	$1,342
Indiana	25	$662	$630 – $2,131	1.1×	$1,463
Iowa	49	$655	$449 – $916	1.1×	$891
Kansas	52	$870	$537 – $1,158	1.4×	$1,003
Kentucky	50	$898	$616 – $1,240	1.5×	$1,560
Louisiana	29	$561	$498 – $761	0.9×	$700
Maine	9	$589	$443 – $961	1.0×	$838
Maryland	9	$669	$578 – $879	1.1×	$722
Massachusetts	9	$860	$732 – $1,035	1.4×	$1,382
Michigan	30	$594	$175 – $855	1.0×	$370
Minnesota	31	$794	$617 – $1,215	1.3×	$1,229
Mississippi	21	$535	$436 – $563	0.9×	$874
Missouri	31	$585	$562 – $622	1.0×	$1,004
Montana	20	$644	$559 – $1,207	1.1×	$1,145
Nebraska	32	$633	$513 – $851	1.0×	$1,001
Nevada	9	$2,170	$1,246 – $2,170	3.6×	$2,580
New Hampshire	5	$765	$734 – $5,989	1.3×	$4,429
New Jersey	22	$1,443	$846 – $1,943	2.4×	$951
New Mexico	11	$621	$589 – $746	1.0×	$1,402
New York	38	$743	$668 – $814	1.2×	$848
North Carolina	22	$630	$583 – $1,438	1.0×	$1,495
North Dakota	11	$701	$500 – $925	1.2×	$865
Ohio	51	$618	$567 – $1,110	1.0×	$1,737
Oklahoma	37	$590	$535 – $920	1.0×	$601
Oregon	24	$933	$735 – $1,412	1.5×	$2,160
Pennsylvania	60	$650	$586 – $1,022	1.1×	$1,288
Rhode Island	5	$955	$701 – $1,129	1.6×	$1,046
South Carolina	27	$594	$576 – $827	1.0×	$1,724
South Dakota	12	$1,393	$1,179 – $1,720	2.3×	$1,688
Tennessee	22	$588	$578 – $630	1.0×	$456
Texas	101	$823	$613 – $1,249	1.4×	$1,173
Utah	21	$3,174	$628 – $3,547	5.2×	$3,111
Vermont	9	$641	$564 – $1,048	1.1×	$1,061
Virginia	19	$610	$610 – $1,895	1.0×	$1,160
Washington	20	$758	$574 – $1,089	1.2×	$1,290
West Virginia	9	$772	$580 – $1,168	1.3×	$1,666
Wisconsin	26	$767	$542 – $1,291	1.3×	$934
Wyoming	10	$1,294	$776 – $1,440	2.1×	$1,381

middle half of hospitalsstate medianMedicare rate · a dotted end means the range runs past $2,000

States with at least 5 hospitals in our data (47 states). 4 smaller states are counted in the national figures but not listed — a median of two or three hospitals says more about those hospitals than about the state.

Get the data

Hospital-level and insurer-level rates for this procedure are in the full dataset. A free three-procedure sample (brain MRI, head CT, diagnostic colonoscopy) is open under CC BY 4.0: DOI 10.5281/zenodo.23199844 · Kaggle.

Frequently asked questions

How much does a level 5 (most severe) emergency room visit cost in the US?: Across 1,223 hospitals that publish federally required price files, the median negotiated rate is $712, and the middle half of hospitals fall between $574 and $1,130. Self-pay cash prices have a median of $1,160 across the 996 hospitals that list one. What you pay out of pocket depends on your deductible, coinsurance and network.
Why do ER Visit (Level 5) prices vary so much?: Each hospital negotiates separately with each insurer. In these files the priciest tenth of hospitals negotiated more than 5.3 times what the cheapest tenth did, and state medians run from $535 in Mississippi to $3,174 in Utah.
Is the cash price cheaper than using insurance?: Sometimes. At 312 of the 996 hospitals that list a cash price (31%), it is lower than that hospital's own median negotiated rate. If you have a high deductible, ask the hospital for its self-pay price before you book.
What is the Medicare rate shown here?: $608 is the CMS national outpatient (OPPS) payment rate for this service (July 2026). We show it as a government baseline: the national median negotiated rate is 1.2 times it.

Other emergency room prices

ER Visit (Level 3)

median $307 · 1,220 hospitals

ER Visit (Level 4)

median $495 · 1,224 hospitals

See all 30 procedures →