Cost of a ER Visit (High) Visit
in Pennsylvania
Reviewed by Momentary Medical Group West PC
Pennsylvania's emergency departments handle over 5 million visits annually, with high-severity cases accounting for approximately 15% of all ER encounters across the state's 170+ hospitals. An ER Visit (High) in Pennsylvania typically costs between $55 and $334, with a median negotiated rate of $88 based on transparency data from over 2,200 active providers. Pennsylvania residents can browse emergency departments and urgent care centers throughout the Commonwealth to compare costs and verify insurance coverage before seeking care.
Average
$159
Median
$88
Lowest
$55
Highest
$334
Providers
2,214
16% below national average
Compare Similar Procedures
How does er visit (high severity) compare to related procedures in Pennsylvania?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| ER Visit (Low Severity) Emergency department visit, low severity | 99283 | $47 | $72 | $693 | 2,351 |
| ER Visit (Moderate Severity) Emergency department visit, moderate severity | 99284 | $55 | $88 | $431 | 2,690 |
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 Pennsylvania
These hospitals in Pennsylvania are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
WASHINGTON, PA
ROYERSFORD, PA
YORK, PA
WYOMISSING, PA
MUNCY, PA
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 Pennsylvania
Pennsylvania's emergency care costs run approximately 9% above the national average, reflecting the state's mix of high-cost urban markets in Philadelphia and Pittsburgh alongside more affordable rural regions across the Commonwealth's 67 counties. The state's healthcare landscape features intense competition between major health systems like UPMC, Penn Medicine, and Geisinger, influencing pricing strategies across different geographic markets.
Urban vs. Rural Provider Availability
Pennsylvania's rural counties face emergency department closures and consolidation, forcing patients to travel longer distances to facilities in cities like Erie, Scranton, or Allentown, which can drive up costs due to reduced competition. Urban areas around Philadelphia and Pittsburgh maintain multiple emergency options including academic medical centers, community hospitals, and freestanding emergency departments, creating more competitive pricing pressures.
Facility Type and Overhead Costs
Hospital-based emergency departments in Pennsylvania carry higher overhead costs due to 24/7 staffing requirements, advanced equipment, and regulatory compliance, particularly at major health systems like Jefferson Health and Tower Health. Independent and freestanding emergency centers often offer lower facility fees but may lack the comprehensive capabilities of full-service hospital emergency departments for truly high-severity cases.
Insurance Market Competition in Pennsylvania
The Commonwealth's insurance market includes regional dominance by Highmark in western Pennsylvania and Independence Blue Cross in the southeast, alongside national carriers like UnitedHealthcare and Aetna competing for market share. This competitive landscape creates varying negotiated rates between insurers and emergency providers, with some health systems offering preferred pricing to specific insurance networks.
Physician Supply and Demand in Pennsylvania
With over 2,200 emergency medicine providers active across Pennsylvania, the state maintains adequate physician supply in most urban areas while facing shortages in rural counties that rely on locum tenens physicians and telemedicine support. Higher physician supply in metropolitan areas typically correlates with more competitive pricing and shorter wait times, while rural areas may see premium pricing due to limited provider availability.
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 Pennsylvania
What is the average cost of a ER Visit (High) visit in Pennsylvania without insurance?
Does Pennsylvania Medicaid cover ER Visit (High) visits?
How do I find an affordable ER Visit (High) near me in Pennsylvania?
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 Pennsylvania?
How does telemedicine affect the cost of seeing a ER Visit (High) in Pennsylvania?
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 |