How much will a sprained ankle cost me in the ER?
You sprain your ankle badly, and aren't sure if it's broken. It's Friday evening, so you head to the ER to have it x-rayed. At triage you ask 'how much might this cost me?' Typically, nobody working in the hospital at that moment will be able to even take a guess.
A landmark study published in PLOS ONE by researchers at UCSF looked at the bills for over 8,000 emergency department visits across California hospitals. The prices ranged wildly for identical conditions: Sprains and strains: $4 to $24,110. Headache: $15 to $17,797. Kidney stone: $128 to $39,408. Upper respiratory infection: $28 to $28,000.
Why such extreme variation?
The study found that the difference wasn't explained by severity, insurance status, or hospital quality. Instead, prices were driven by arbitrary 'chargemaster' rates—inflated price lists that hospitals use as starting points for negotiation. Uninsured patients often face these full charges, while insurance companies negotiate steep discounts.
What can you do about it?
First, consider whether the ER is necessary. Many sprains and minor injuries can be evaluated at urgent care centers for a fraction of the cost. Second, if you do go to the ER, know that you can negotiate. Request an itemized bill, compare it to Medicare rates, and ask about financial assistance programs.
At My Doctor Medical Group, we help our patients navigate these decisions before they arise. Having a doctor who understands the cost landscape and can guide you to appropriate, cost-effective care is one of the many benefits of concierge medicine. Sometimes a phone call to your doctor at 6pm on a Friday can save you thousands of dollars—and unnecessary stress.
