ER cost analysis
Emergency room visits can cost dramatically different amounts depending on where you live. In some states, a typical visit can be hundreds — or even thousands — of dollars more than in others.
In our analysis of ER bills, sample reports, and early user data, we identified the states where costs tend to be the highest.
These rankings use typical billed ER visit ranges from our state-level cost dataset. Actual patient responsibility depends on insurance, deductibles, visit complexity, and hospital billing practices.
| State | Typical ER Cost Range | Average Facility Fee | Notes |
|---|---|---|---|
| New York | $1,200–$8,600 | $1,710–$2,850 | High-cost urban hospital systems and large academic medical centers can push billed ER charges toward the upper end of the range. |
| California | $1,200–$8,500 | $1,710–$2,850 | Large metro areas, high labor costs, and major hospital systems often contribute to higher emergency department pricing. |
| Massachusetts | $1,150–$8,400 | $1,665–$2,775 | Boston-area teaching hospitals and complex regional care networks can make moderate ER visits more expensive than in many states. |
| Alaska | $1,100–$8,200 | $1,620–$2,700 | Limited hospital access, geographic distance, and transport costs can increase the total cost of emergency care. |
| Connecticut | $1,100–$8,000 | $1,575–$2,625 | Regional teaching hospitals and higher facility fees are common drivers of larger ER bills in the state. |
| New Jersey | $1,100–$8,000 | $1,575–$2,625 | Dense hospital markets and historically high chargemaster prices can lead to larger billed amounts before insurance adjustments. |
| Rhode Island | $1,050–$7,800 | $1,530–$2,550 | Rhode Island's small geography means most ER care funnels through Lifespan and Care New England systems, which produce relatively consistent — and elevated — pricing. |
| Washington | $1,050–$7,800 | $1,530–$2,550 | Seattle-area hospital systems — UW Medicine, Swedish, Virginia Mason — tend to bill at the higher end, particularly for visits involving imaging or specialty consults. |
| Illinois | $1,000–$7,800 | $1,485–$2,475 | Chicago hospital systems regularly produce ER bills of $5,000+ for moderate-complexity visits, and academic medical centers can run substantially higher than community hospitals in the same neighborhood. |
| Hawaii | $1,000–$7,600 | $1,485–$2,475 | Limited hospital capacity across islands and visitor-related out-of-network issues can increase billed ER costs. |
Typical ER cost: $1,200–$8,600
High-cost urban hospital systems and large academic medical centers can push billed ER charges toward the upper end of the range. Costs can still vary widely by hospital, visit level, imaging, labs, and insurance status.
Typical ER cost: $1,200–$8,500
Large metro areas, high labor costs, and major hospital systems often contribute to higher emergency department pricing. Costs can still vary widely by hospital, visit level, imaging, labs, and insurance status.
Typical ER cost: $1,150–$8,400
Boston-area teaching hospitals and complex regional care networks can make moderate ER visits more expensive than in many states. Costs can still vary widely by hospital, visit level, imaging, labs, and insurance status.
Typical ER cost: $1,100–$8,200
Limited hospital access, geographic distance, and transport costs can increase the total cost of emergency care. Costs can still vary widely by hospital, visit level, imaging, labs, and insurance status.
Typical ER cost: $1,100–$8,000
Regional teaching hospitals and higher facility fees are common drivers of larger ER bills in the state. Costs can still vary widely by hospital, visit level, imaging, labs, and insurance status.
Typical ER cost: $1,100–$8,000
Dense hospital markets and historically high chargemaster prices can lead to larger billed amounts before insurance adjustments. Costs can still vary widely by hospital, visit level, imaging, labs, and insurance status.
Typical ER cost: $1,050–$7,800
Rhode Island's small geography means most ER care funnels through Lifespan and Care New England systems, which produce relatively consistent — and elevated — pricing. Costs can still vary widely by hospital, visit level, imaging, labs, and insurance status.
Typical ER cost: $1,050–$7,800
Seattle-area hospital systems — UW Medicine, Swedish, Virginia Mason — tend to bill at the higher end, particularly for visits involving imaging or specialty consults. Costs can still vary widely by hospital, visit level, imaging, labs, and insurance status.
Typical ER cost: $1,000–$7,800
Chicago hospital systems regularly produce ER bills of $5,000+ for moderate-complexity visits, and academic medical centers can run substantially higher than community hospitals in the same neighborhood. Costs can still vary widely by hospital, visit level, imaging, labs, and insurance status.
Typical ER cost: $1,000–$7,600
Limited hospital capacity across islands and visitor-related out-of-network issues can increase billed ER costs. Costs can still vary widely by hospital, visit level, imaging, labs, and insurance status.
Higher hospital operating costs: Staffing, real estate, specialized equipment, and regional overhead can influence the billed price of emergency care.
Insurance variations: Network contracts, deductibles, and out-of-network rules affect what patients ultimately owe after adjustments.
Urban pricing: Large metro hospitals and academic medical centers often bill more than smaller community hospitals.
Facility fee differences: The ER facility fee can be one of the largest charges and may vary by visit level.
A higher-cost state does not mean every bill is correct, and a lower-cost state does not mean every bill is fair. ER bills should still be reviewed for duplicate lines, vague charges, high facility fees, and separate provider bills that may arrive later.
The same lab, supply, or monitoring line appears more than once.
Generic supply or room charges can be hard to understand.
The ER level may drive a large portion of the bill.
The hospital, ER doctor, and radiology group may bill separately.
Upload your bill to review line items, identify charges worth asking about, and see where the biggest costs may be coming from.