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Illinois

Cost of a ER Visit (High) Visit
in Illinois

Reviewed by Momentary Medical Group West PC

Illinois's healthcare market, concentrated around Chicago's major academic medical centers, maintains 13,925 active emergency medicine providers across the state. For a ER Visit (High) visit, patients typically pay between $80 and $569, with a median out-of-pocket cost of $206. The state's expanded Medicaid program and competitive insurance marketplace help moderate costs compared to neighboring states, though patients can browse all providers in Illinois to find the most affordable options.

Average

$285

Median

$206

Lowest

$80

Highest

$569

Providers

13,925

National avg: $189Illinois: $285

51% above national average

Compare Similar Procedures

How does er visit (high severity) compare to related procedures in Illinois?

ProcedureCPTLowMedianHighProviders
ER Visit (Low Severity)

Emergency department visit, low severity

99283$57$90$25215,690
ER Visit (Moderate Severity)

Emergency department visit, moderate severity

99284$80$158$43114,611

Important: These are cost estimates only — not a quote and not medical advice.

The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 99285Emergency department visit, high severity). They represent what a patient might pay without insurance.

Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.

This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.

Where this data comes from & what CPT 99285 covers

Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99285 (Emergency department visit, high severity), as mandated by the CMS Price Transparency Rule.

What CPT 99285 covers: the provider's professional fee for er visit (high severity). It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.

How to read this data

Negotiated Rate

The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.

P5, Median, P95

P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.

What this does not tell you

These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.

Top-Rated Hospitals in Illinois

These hospitals in Illinois are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.

5/5
96% would recommend133 patient surveys
5/5
91% would recommend122 patient surveys
MEMORIAL HOSPITAL

CARTHAGE, IL

5/5
87% would recommend114 patient surveys
5/5
79% would recommend117 patient surveys
5/5
78% would recommend107 patient surveys

Hospital ratings are based on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey data published by CMS.

Why ER Visit (High) Visit Costs Vary Across Illinois

Illinois emergency care costs run approximately 10% above national averages, driven by Chicago's concentration of major academic medical centers and the state's higher-than-average healthcare worker wages. The Prairie State's geography creates distinct cost regions, from Chicago's dense provider networks to rural counties where emergency access may require longer transport times.

Urban vs. Rural Provider Availability

Chicago's metropolitan area contains dozens of emergency departments within a 50-mile radius, while rural Illinois counties may have only one hospital serving multi-county regions. This geographic disparity affects both access and pricing, as rural emergency departments often charge higher rates to cover fixed costs across smaller patient populations.

Facility Type and Overhead Costs

Illinois features major health systems like Northwestern Medicine, Advocate Health, and Rush University Medical Center that operate hospital-based emergency departments with higher overhead costs. Independent freestanding emergency departments, particularly in suburban markets, may offer lower facility fees but similar physician charges for high-acuity care.

Insurance Market Competition in Illinois

The competitive Illinois market with major players BCBS IL, UHC, and Aetna creates downward pressure on negotiated emergency care rates. This competition particularly benefits patients in the Chicago metropolitan area, where insurers compete aggressively for employer-sponsored group coverage that includes emergency benefits.

Physician Supply and Demand in Illinois

With 13,925 active emergency medicine providers, Illinois maintains adequate emergency physician supply in urban areas while facing shortages in rural regions. This supply-demand imbalance contributes to pricing variations, as rural emergency departments may charge premium rates to attract and retain emergency physicians willing to serve less populated areas.

JP

Jayant Panwar

CEO, Momentary Labs · San Francisco, CA

Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.

The cost figures on this page reflect his ongoing work to make this data accessible to patients.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — ER Visit (High) Costs in Illinois

What is the average cost of a ER Visit (High) visit in Illinois without insurance?

Uninsured patients in Illinois can expect to pay between $80 and $569 for a high-acuity emergency visit, with a median cost of $206. These rates represent negotiated prices between insurers and providers, while self-pay patients may receive discounts of 30-50% when paying promptly. Many Illinois hospitals offer financial assistance programs for uninsured patients based on income eligibility.

Does Illinois Medicaid cover ER Visit (High) visits?

Yes, Illinois expanded Medicaid covers emergency department visits including high-acuity care for qualifying residents. Medicaid patients typically have minimal copays for emergency services, and life-threatening emergencies are covered regardless of prior authorization requirements. Illinois Medicaid also covers follow-up care related to emergency treatment when medically necessary.

How do I find an affordable ER Visit (High) near me in Illinois?

Compare costs between hospital emergency departments and freestanding emergency centers in your area, as pricing can vary significantly. Ask about self-pay discounts if you're uninsured, and consider community health centers for urgent but non-emergency care. Illinois hospital financial counselors can help determine eligibility for charity care or payment plans based on income.

What is the difference in cost between an initial consultation and a follow-up visit?

Emergency department visits are typically billed at the same rate regardless of whether it's your first visit or a return visit, as emergency care is based on acuity level rather than patient history. The $206 median cost in Illinois applies to high-acuity visits requiring immediate attention, complex decision-making, and often multiple diagnostic tests or procedures.

Can I use an HSA or FSA to pay for a ER Visit (High) visit in Illinois?

Yes, Health Savings Accounts and Flexible Spending Accounts can be used for emergency department visits as they qualify as eligible medical expenses. This includes both physician fees and facility charges associated with emergency care. Keep all receipts and documentation for HSA/FSA reimbursement purposes, including any follow-up care related to your emergency visit.

How does telemedicine affect the cost of seeing a ER Visit (High) in Illinois?

Telemedicine cannot replace high-acuity emergency care that requires immediate physical examination, diagnostic testing, or procedures. However, telehealth consultations can help determine whether symptoms require emergency attention or can be managed with urgent care, potentially saving unnecessary emergency department costs. Illinois expanded telehealth coverage during the pandemic, making remote triage more accessible for non-emergency medical questions.

Click a state to compare costs

Average Visit Cost

$114
$430

Office visit (CPT 99285)

Compare With Other States

RankStateAverage
1Wisconsin
Range: $73$940
$430
2New Hampshire
Range: $150$446
$294
3Illinois
Range: $80$569
$285
4Iowa
Range: $85$538
$275
5Louisiana
Range: $98$536
$261
6New York
Range: $80$543
$260
7Maine
Range: $170$337
$251
8Nebraska
Range: $123$422
$236
9Washington
Range: $80$379
$224
10Colorado
Range: $80$390
$219
11New Mexico
Range: $88$389
$218
12Wyoming
Range: $88$385
$217
13Vermont
Range: $98$356
$216
14Rhode Island
Range: $80$429
$202
15Massachusetts
Range: $80$428
$202
16Georgia
Range: $85$333
$198
17North Carolina
Range: $80$330
$188
18District of Columbia
Range: $85$305
$185
19Maryland
Range: $88$298
$183
20Michigan
Range: $80$318
$183
21Utah
Range: $80$317
$182
22New Jersey
Range: $60$348
$182
23Ohio
Range: $85$287
$181
24Mississippi
Range: $126$250
$181
25California
Range: $80$374
$181
26Hawaii
Range: $80$313
$179
27Arkansas
Range: $85$282
$178
28Virginia
Range: $88$293
$177
29Tennessee
Range: $85$259
$170
30South Carolina
Range: $80$287
$170
31Missouri
Range: $88$239
$168
32Minnesota
Range: $91$312
$167
33Oklahoma
Range: $85$246
$166
34Kansas
Range: $88$243
$166
35Alabama
Range: $80$257
$160
36Pennsylvania
Range: $55$334
$159
37Arizona
Range: $80$250
$157
38Indiana
Range: $85$298
$157
39West Virginia
Range: $88$281
$155
40Delaware
Range: $85$203
$155
41Kentucky
Range: $80$296
$155
42Nevada
Range: $85$267
$154
43Alaska
Range: $80$292
$151
44Connecticut
Range: $55$320
$148
45Idaho
Range: $80$275
$148
46Oregon
Range: $80$250
$142
47Texas
Range: $80$257
$142
48Montana
Range: $80$213
$124
49North Dakota
Range: $91$177
$122
50South Dakota
Range: $98$161
$119
51Florida
Range: $35$246
$114
ER Visit (High Severity) in Other States