Cost of a ER Visit (High) Visit
in Kentucky
Reviewed by Momentary Medical Group West PC
Kentucky's healthcare system serves a population where rural counties often lack adequate emergency care access, leading to higher utilization of urban emergency departments for high-severity cases. For an ER Visit (High) in Kentucky, patients typically pay between $80 and $295, with a median out-of-pocket cost of $88 based on negotiated insurance rates. With over 1,050 active emergency care providers across the state, patients can browse all available options to find the most cost-effective care for their urgent medical needs.
Average
$155
Median
$88
Lowest
$80
Highest
$296
Providers
1,050
18% below national average
Compare Similar Procedures
How does er visit (high severity) compare to related procedures in Kentucky?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| ER Visit (Low Severity) Emergency department visit, low severity | 99283 | $40 | $85 | $139 | 378 |
| ER Visit (Moderate Severity) Emergency department visit, moderate severity | 99284 | $70 | $103 | $246 | 405 |
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 99285 — Emergency 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 Kentucky
These hospitals in Kentucky are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
BEREA, KY
FLEMINGSBURG, KY
LOUISA, KY
LEXINGTON, KY
CYNTHIANA, KY
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 Kentucky
Kentucky's emergency care costs run approximately 5% below the national average, reflecting the state's lower cost of living and healthcare overhead compared to coastal states. However, the state's significant rural population creates unique access challenges, with many counties lacking nearby emergency facilities for high-severity cases.
Urban vs. Rural Provider Availability
Kentucky's mountainous eastern regions and rural western counties often require patients to travel significant distances to reach emergency departments capable of handling high-severity cases. Major metropolitan areas like Louisville and Lexington concentrate advanced emergency services, while smaller towns may only offer basic emergency care before transferring critical patients. This geographic disparity affects both access and cost, as rural transfers can add thousands to emergency care expenses.
Facility Type and Overhead Costs
Hospital-based emergency departments dominate Kentucky's emergency care landscape, with major health systems like Norton Healthcare, Baptist Health, and UK HealthCare operating the largest facilities. University hospitals in Louisville and Lexington typically charge premium rates due to their academic medical center status and specialized trauma capabilities. Independent community hospitals often provide more cost-effective emergency care for high-severity cases that don't require tertiary care resources.
Insurance Market Competition in Kentucky
Kentucky's insurance market sees moderate competition between Anthem, UHC, and Humana, with regional insurers also serving specific geographic areas. This competitive environment helps keep negotiated rates reasonable compared to states with dominant single insurers. However, rural areas may have fewer network options, potentially leading to higher out-of-network costs for emergency care when patients cannot reach preferred facilities.
Physician Supply and Demand in Kentucky
With over 1,050 emergency care providers active across Kentucky, the state maintains adequate emergency physician coverage in urban areas while facing shortages in rural regions. This supply distribution affects both wait times and pricing, as rural emergency departments may charge higher rates to attract and retain emergency physicians. The concentration of specialists in Louisville and Lexington also influences referral patterns and costs for high-severity emergency cases requiring subspecialty care.
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.
Frequently Asked Questions — ER Visit (High) Costs in Kentucky
What is the average cost of a ER Visit (High) visit in Kentucky without insurance?
Does Kentucky Medicaid cover ER Visit (High) visits?
How do I find an affordable ER Visit (High) near me in Kentucky?
What is the difference in cost between an initial consultation and a follow-up visit?
Can I use an HSA or FSA to pay for a ER Visit (High) visit in Kentucky?
How does telemedicine affect the cost of seeing a ER Visit (High) in Kentucky?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 99285)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $940 | $430 |
| 2 | New Hampshire Range: $150 – $446 | $294 |
| 3 | Illinois Range: $80 – $569 | $285 |
| 4 | Iowa Range: $85 – $538 | $275 |
| 5 | Louisiana Range: $98 – $536 | $261 |
| 6 | New York Range: $80 – $543 | $260 |
| 7 | Maine Range: $170 – $337 | $251 |
| 8 | Nebraska Range: $123 – $422 | $236 |
| 9 | Washington Range: $80 – $379 | $224 |
| 10 | Colorado Range: $80 – $390 | $219 |
| 11 | New Mexico Range: $88 – $389 | $218 |
| 12 | Wyoming Range: $88 – $385 | $217 |
| 13 | Vermont Range: $98 – $356 | $216 |
| 14 | Rhode Island Range: $80 – $429 | $202 |
| 15 | Massachusetts Range: $80 – $428 | $202 |
| 16 | Georgia Range: $85 – $333 | $198 |
| 17 | North Carolina Range: $80 – $330 | $188 |
| 18 | District of Columbia Range: $85 – $305 | $185 |
| 19 | Maryland Range: $88 – $298 | $183 |
| 20 | Michigan Range: $80 – $318 | $183 |
| 21 | Utah Range: $80 – $317 | $182 |
| 22 | New Jersey Range: $60 – $348 | $182 |
| 23 | Ohio Range: $85 – $287 | $181 |
| 24 | Mississippi Range: $126 – $250 | $181 |
| 25 | California Range: $80 – $374 | $181 |
| 26 | Hawaii Range: $80 – $313 | $179 |
| 27 | Arkansas Range: $85 – $282 | $178 |
| 28 | Virginia Range: $88 – $293 | $177 |
| 29 | Tennessee Range: $85 – $259 | $170 |
| 30 | South Carolina Range: $80 – $287 | $170 |
| 31 | Missouri Range: $88 – $239 | $168 |
| 32 | Minnesota Range: $91 – $312 | $167 |
| 33 | Oklahoma Range: $85 – $246 | $166 |
| 34 | Kansas Range: $88 – $243 | $166 |
| 35 | Alabama Range: $80 – $257 | $160 |
| 36 | Pennsylvania Range: $55 – $334 | $159 |
| 37 | Arizona Range: $80 – $250 | $157 |
| 38 | Indiana Range: $85 – $298 | $157 |
| 39 | West Virginia Range: $88 – $281 | $155 |
| 40 | Delaware Range: $85 – $203 | $155 |
| 41 | Kentucky Range: $80 – $296 | $155 |
| 42 | Nevada Range: $85 – $267 | $154 |
| 43 | Alaska Range: $80 – $292 | $151 |
| 44 | Connecticut Range: $55 – $320 | $148 |
| 45 | Idaho Range: $80 – $275 | $148 |
| 46 | Oregon Range: $80 – $250 | $142 |
| 47 | Texas Range: $80 – $257 | $142 |
| 48 | Montana Range: $80 – $213 | $124 |
| 49 | North Dakota Range: $91 – $177 | $122 |
| 50 | South Dakota Range: $98 – $161 | $119 |
| 51 | Florida Range: $35 – $246 | $114 |