Cost of a ER Visit (Moderate) Visit
in Pennsylvania
Reviewed by Momentary Medical Group West PC
Pennsylvania's healthcare landscape includes major academic medical centers in Philadelphia and Pittsburgh alongside rural hospitals serving Appalachian communities, creating diverse pricing structures for emergency care. An ER Visit (Moderate) in Pennsylvania typically costs between $55 and $431, with a median negotiated rate of $88 across the state's 2,690 active emergency providers. These rates reflect what insurers actually pay facilities based on Transparency in Coverage data, offering patients realistic cost expectations when seeking moderate-severity emergency care throughout Pennsylvania.
Average
$191
Median
$88
Lowest
$55
Highest
$431
Providers
2,690
35% above national average
Compare Similar Procedures
How does er visit (moderate 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 (High Severity) Emergency department visit, high severity | 99285 | $55 | $88 | $334 | 2,214 |
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 99284 — Emergency department visit, moderate 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 99284 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99284 (Emergency department visit, moderate severity), as mandated by the CMS Price Transparency Rule.
What CPT 99284 covers: the provider's professional fee for er visit (moderate 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 (Moderate) Visit Costs Vary Across Pennsylvania
Pennsylvania's emergency care costs run approximately 9% above national averages, reflecting the state's mix of high-cost urban markets in Philadelphia and Pittsburgh alongside more affordable rural regions. The state's healthcare landscape includes major academic medical centers, community hospitals, and critical access hospitals serving Pennsylvania's diverse geography from Delaware Valley suburbs to Appalachian mountain communities.
Urban vs. Rural Provider Availability
Pennsylvania's 67 counties include dense metropolitan areas around Philadelphia and Pittsburgh with multiple emergency options, while rural counties in north-central and southwestern Pennsylvania may have limited emergency department choices. Urban emergency departments typically charge higher rates due to increased overhead costs and higher patient acuity, while rural hospitals may offer more competitive pricing but potentially require transfers for complex cases. The state's geography creates significant travel distances in rural areas, making local emergency department choice particularly important for cost planning.
Facility Type and Overhead Costs
Major health systems like UPMC, Jefferson Health, and Penn Medicine operate numerous emergency departments throughout Pennsylvania with varying cost structures based on facility type and trauma center designation. Teaching hospitals affiliated with medical schools typically have higher overhead costs reflected in emergency visit pricing, while community hospitals may offer more competitive rates for moderate-severity visits. Freestanding emergency departments, though less common in Pennsylvania than other states, provide another pricing option distinct from traditional hospital-based emergency care.
Insurance Market Competition in Pennsylvania
Highmark dominates western Pennsylvania while Independence Blue Cross holds strong market share in the Philadelphia region, with UnitedHealthcare and other national carriers providing competition statewide. This regional insurer concentration can limit negotiated rate competition in some areas, particularly where a single health system and single insurer have significant market power. The state's insurance market structure affects emergency department pricing through varying negotiation leverage between insurers and hospital systems.
Physician Supply and Demand in Pennsylvania
With 2,690 active emergency care providers reported in transparency data, Pennsylvania maintains relatively strong emergency physician availability compared to many states, though distribution varies significantly between urban and rural areas. Philadelphia and Pittsburgh attract emergency medicine specialists to academic medical centers and trauma centers, while rural areas face ongoing challenges recruiting and retaining emergency physicians. This supply-demand imbalance affects pricing and wait times, with urban areas potentially having higher costs but more immediate availability, while rural areas may offer lower costs but longer travel distances.
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 (Moderate) Costs in Pennsylvania
What is the average cost of a ER Visit (Moderate) visit in Pennsylvania without insurance?
Does Pennsylvania Medicaid cover ER Visit (Moderate) visits?
How do I find an affordable ER Visit (Moderate) 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 (Moderate) visit in Pennsylvania?
How does telemedicine affect the cost of seeing a ER Visit (Moderate) in Pennsylvania?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 99284)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $73 – $647 | $311 |
| 2 | Illinois Range: $80 – $431 | $223 |
| 3 | Iowa Range: $80 – $371 | $205 |
| 4 | New Hampshire Range: $102 – $307 | $202 |
| 5 | Pennsylvania Range: $55 – $431 | $191 |
| 6 | New York Range: $67 – $374 | $183 |
| 7 | Rhode Island Range: $62 – $374 | $177 |
| 8 | Maine Range: $116 – $233 | $172 |
| 9 | Massachusetts Range: $62 – $368 | $170 |
| 10 | Nebraska Range: $83 – $291 | $165 |
| 11 | Washington Range: $80 – $259 | $161 |
| 12 | Michigan Range: $80 – $291 | $158 |
| 13 | New Mexico Range: $85 – $266 | $158 |
| 14 | Wyoming Range: $85 – $262 | $157 |
| 15 | Colorado Range: $80 – $267 | $157 |
| 16 | Vermont Range: $80 – $257 | $156 |
| 17 | Georgia Range: $84 – $246 | $151 |
| 18 | California Range: $80 – $258 | $142 |
| 19 | Indiana Range: $80 – $258 | $142 |
| 20 | Kentucky Range: $70 – $246 | $140 |
| 21 | North Carolina Range: $80 – $231 | $139 |
| 22 | District of Columbia Range: $80 – $217 | $138 |
| 23 | West Virginia Range: $62 – $174 | $137 |
| 24 | Utah Range: $80 – $228 | $135 |
| 25 | Maryland Range: $80 – $206 | $132 |
| 26 | New Jersey Range: $60 – $237 | $131 |
| 27 | Hawaii Range: $80 – $217 | $130 |
| 28 | Arkansas Range: $80 – $194 | $130 |
| 29 | Virginia Range: $81 – $202 | $129 |
| 30 | Tennessee Range: $85 – $187 | $128 |
| 31 | South Carolina Range: $80 – $206 | $128 |
| 32 | Ohio Range: $75 – $197 | $127 |
| 33 | Missouri Range: $85 – $167 | $124 |
| 34 | Alabama Range: $80 – $195 | $124 |
| 35 | Oklahoma Range: $85 – $169 | $123 |
| 36 | Kansas Range: $86 – $167 | $123 |
| 37 | Texas Range: $80 – $196 | $122 |
| 38 | Arizona Range: $80 – $187 | $122 |
| 39 | Mississippi Range: $86 – $165 | $121 |
| 40 | Idaho Range: $80 – $194 | $121 |
| 41 | Delaware Range: $80 – $157 | $120 |
| 42 | Minnesota Range: $62 – $233 | $119 |
| 43 | Nevada Range: $84 – $184 | $119 |
| 44 | Connecticut Range: $55 – $211 | $118 |
| 45 | Alaska Range: $80 – $194 | $118 |
| 46 | Louisiana Range: $62 – $150 | $104 |
| 47 | Oregon Range: $62 – $183 | $102 |
| 48 | Montana Range: $62 – $145 | $96 |
| 49 | Florida Range: $35 – $190 | $95 |
| 50 | North Dakota Range: $62 – $121 | $82 |
| 51 | South Dakota Range: $62 – $121 | $82 |