Here’s what you need to know about free-standing emergency rooms


Bryan Piccola of Frisco, Texas, never expected to pay nearly $3,000 for just five stitches. But when he cut his finger last year, he elected to go to a free-standing First Choice Emergency Room just a few miles from his house. He was assured the bill wouldn’t be too bad. The amount he paid was discounted from an initial $5,000

And Piccola isn’t the only one to be blindsided by emergency room bills. Other patients say they’ve also received bills in the thousands. High prices often come standard at free-standing emergency rooms. But what are these free-standing ERs? And should you avoid them at all costs?

What Is A Free-Standing Emergency Room?

Free-standing emergency rooms are exactly what they sound like: an ER that’s not attached to a hospital. It’s not a clinic, and it’s not urgent care. But while it might not be attached to a hospital, it still comes with hospital-like prices.

There are more than 400 free-standing ERs across 32 states that provide quick and easy access to care. Billed as the ER without the horrific wait time, they are popular among people who don’t want to drive (or wait) to get seen by a nurse or doctor. But with care comes cost, and running an emergency room means high bills for patients and owners alike.


Buyer Beware—Your Bill Might Be Huge

Where do these high costs come from, though? Why are people getting charged thousands of dollars for antibiotics or just a few stitches?

Well, emergency care requires expensive imaging, such as MRIs and CT scans. Laboratory equipment, 24-hour facilities and round-the-clock care all add up.

In fact, according to an analysis of one insurer’s Texas data by Rice University economist Vivian Ho, patients with the same diagnosis are billed at a rate 10 times higher at free-standing ERs than at urgent-care centers. Ho also found that visits to free-standing ERs more than tripled between 2012 and 2015.

People may think they’re visiting an urgent-care facility when they’re actually visiting a free-standing emergency room. This can lead to confusion when they see the bill.

“Many patients mistakenly think that freestanding emergency departments and urgent care clinics are similar, because they are often conveniently located in neighborhood shopping centers with modest storefronts,” Ho said in a news release.

Costs can be higher at these free-standing locations for a number of reasons. One is that clinics can’t send a bill to Medicare or Medicaid without being affiliated with a hospital. Another is that free-standing emergency rooms blame insurance companies for high bills, alleging that they deny or underpay claims. In that same vein, insurers blame the ERs for charging high prices that the companies can’t cover.


Should You Avoid All Free-Standing ERs?

Ultimately, it depends on what you’re looking for. Do you need care ASAP? Do you have a minor injury, such as a cut or scrape, or are you having a major medical emergency? All of these questions can help inform your decision between a free-standing ER, the hospital or an urgent-care clinic.

“These setups are a lot more beneficial for the patient as far as time concern and quickness and availability,” said Michael Balli, 24, who went to a free-standing ER in Houston after spending a night dehydrated from vomiting. “If you’re not the most serious person at the ER, if you’re not the one bleeding out or having a heart attack, you’re probably going to get last on the totem pole.”

About the Author

Jessica Suss

An aspiring food and health writer, native Chicagoan, and nut butter enthusiast. Jessica is also the creator of BiteMeBlog, but don't call her a foodie More.

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