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Virginia

Cost of a ER Visit (High) Visit
in Virginia

Reviewed by Momentary Medical Group West PC

Virginia's diverse healthcare landscape spans from advanced medical centers in Northern Virginia to rural critical access hospitals, with over 5,300 providers offering high-severity emergency care across the Commonwealth. Patients typically pay between $88 and $293 for ER Visit (High) services, with a median out-of-pocket cost around $150 based on negotiated insurance rates. With numerous active ER Visit (High) providers throughout Virginia's 95 counties and 38 independent cities, patients can browse all available emergency care options across the state.

Average

$177

Median

$150

Lowest

$88

Highest

$293

Providers

5,338

National avg: $189Virginia: $177

6% below national average

HSA/FSA eligible

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Just $19.99/mo

Compare Similar Procedures

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

ProcedureCPTLowMedianHighProviders
ER Visit (Low Severity)

Emergency department visit, low severity

99283$47$72$1195,393
ER Visit (Moderate Severity)

Emergency department visit, moderate severity

99284$81$103$2025,430

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 Virginia

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

Fort Belvoir Community Hospital

Fort Belvoir, VA

5/5
85% would recommend824 patient surveys
SALEM VA MEDICAL CENTER

SALEM, VA

5/5
80% would recommend397 patient surveys
BUCHANAN GENERAL HOSPITAL

GRUNDY, VA

5/5
73% would recommend171 patient surveys
SENTARA MARTHA JEFFERSON HOSPITAL

CHARLOTTESVILLE, VA

4/5
83% would recommend698 patient surveys
UNIVERSITY OF VIRGINIA MEDICAL CENTER

CHARLOTTESVILLE, VA

4/5
81% would recommend1,098 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 Virginia

Virginia's emergency care costs run approximately 3% above the national average, reflecting the state's mix of high-cost Northern Virginia markets influenced by Washington D.C. proximity and more affordable rural regions throughout the Shenandoah Valley and Southside. The Commonwealth's diverse geography creates significant cost variations between urban academic medical centers and rural critical access hospitals serving smaller communities.

Urban vs. Rural Provider Availability

Northern Virginia's dense provider network around Fairfax and Arlington offers numerous high-end emergency departments but at premium pricing, while rural areas like Southwest Virginia may have longer transport times but significantly lower costs per visit. The state's mountainous terrain and rural counties create access challenges that can affect both emergency response times and facility overhead costs. Richmond, Norfolk, and Virginia Beach provide mid-tier options with good provider availability and moderate pricing compared to the expensive Northern Virginia corridor.

Facility Type and Overhead Costs

Major health systems like Sentara, Bon Secours, HCA Virginia, and Inova dominate Virginia's emergency care landscape, with their hospital-based emergency departments typically charging higher facility fees than independent providers. Academic medical centers such as VCU Health and UVA Health command premium rates due to their trauma center capabilities and resident training programs. Freestanding emergency departments, while less common in Virginia than some states, often offer a middle ground between traditional ERs and urgent care centers.

Insurance Market Competition in Virginia

Anthem Blue Cross Blue Shield holds the largest market share in Virginia, followed by Optima Health (primarily in Tidewater and Northern Virginia) and UHC, creating moderate competition that helps control negotiated rates for emergency services. The state's decision to expand Medicaid brought additional volume to emergency departments while providing better reimbursement than uncompensated care. Virginia's lack of a comprehensive all-payer claims database limits transparency but allows insurers more flexibility in rate negotiations with emergency care providers.

Physician Supply and Demand in Virginia

With over 5,300 providers offering high-severity emergency care, Virginia maintains adequate physician supply in most regions, though rural areas still face emergency medicine shortages that can affect both access and pricing. The state's proximity to Washington D.C. attracts many specialists to Northern Virginia, creating geographic disparities in provider density and competition. Strong emergency medicine residency programs at VCU and other Virginia hospitals help maintain physician supply, though retention in rural areas remains challenging due to lifestyle and compensation factors.

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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 Virginia

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

Without insurance, high-severity emergency visits in Virginia typically range from $88 to $293, with a median cost around $150 based on negotiated rates that hospitals often use as starting points for uninsured patients. However, many Virginia hospitals offer significant self-pay discounts, sometimes reducing these amounts by 30-50% when paid promptly. The final cost depends on the specific treatments, tests, and procedures required during your emergency visit, with complex cases potentially exceeding these baseline amounts.

Does Virginia Medicaid cover ER Visit (High) visits?

Yes, Virginia Medicaid covers high-severity emergency visits with no copayment required for emergency department care. Since Virginia expanded Medicaid in 2019, coverage now extends to adults earning up to 138% of the federal poverty level, significantly improving access to emergency services. Medicaid covers both the facility fees and physician fees associated with emergency care, and prior authorization is never required for true medical emergencies, regardless of which hospital you visit in Virginia.

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

Compare costs between different emergency departments in your area, as community hospitals often charge less than major academic medical centers for similar services. Ask about self-pay discounts if you're uninsured, as many Virginia hospitals offer 30-50% reductions for prompt payment. Consider freestanding emergency departments where available, and remember that emergency care costs are often non-negotiable in true emergencies, making insurance coverage and understanding your benefits the most important factors for managing costs.

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

Emergency department visits don't typically distinguish between initial consultations and follow-up visits in the same way outpatient clinics do, as each emergency visit is treated as a separate acute episode. However, if you return to the emergency department within 72 hours for the same condition, some hospitals may adjust billing or waive certain facility fees. The cost is primarily determined by the complexity and severity of care provided during each individual visit, with high-severity visits commanding the same rate regardless of whether it's your first or subsequent emergency department encounter.

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

Yes, emergency department visits are qualified medical expenses that can be paid using Health Savings Account (HSA) or Flexible Spending Account (FSA) funds. This includes all associated costs such as facility fees, physician fees, diagnostic tests, and any treatments provided during your emergency visit. Keep all receipts and documentation from your emergency care for tax and reimbursement purposes, as HSA and FSA administrators may require proof that the expenses were for qualified medical care.

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

Telemedicine cannot replace high-severity emergency care, as these conditions require immediate hands-on medical intervention, diagnostic testing, and often life-saving procedures that can only be performed in person. However, telehealth services can help determine whether symptoms warrant emergency care or could be managed through urgent care or primary care visits. Virginia has expanded telehealth access since 2020, making it easier to consult with healthcare providers for non-emergency concerns, potentially helping patients avoid unnecessary emergency department visits while ensuring appropriate care for true emergencies.

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
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyoming