Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013;8(2):e55491.
doi: 10.1371/journal.pone.0055491. Epub 2013 Feb 27.

"How much will I get charged for this?" Patient charges for top ten diagnoses in the emergency department

Nolan Caldwell  1 , Tanja Srebotnjak, Tiffany Wang, Renee Hsia
Affiliations

"How much will I get charged for this?" Patient charges for top ten diagnoses in the emergency department

Nolan Caldwell et al. PLoS One. 2013.

Abstract

Objectives: We examined the charges, their variability, and respective payer group for diagnosis and treatment of the ten most common outpatient conditions presenting to the Emergency department (ED).

Methods: We conducted a cross-sectional study of the 2006-2008 Medical Expenditure Panel Survey. Analysis was limited to outpatient visits with non-elderly, adult (years 18-64) patients with a single discharge diagnosis.

Results: We studied 8,303 ED encounters, representing 76.6 million visits. Median charges ranged from $740 (95% CI $651-$817) for an upper respiratory infection to $3437 (95% CI $2917-$3877) for a kidney stone. The median charge for all ten outpatient conditions in the ED was $1233 (95% CI $1199- $1268), with a high degree of charge variability. All diagnoses had an interquartile range (IQR) greater than $800 with 60% of IQRs greater than $1550.

Conclusion: Emergency department charges for common conditions are expensive with high charge variability. Greater acute care charge transparency will at least allow patients and providers to be aware of the emergency department charges patients may face in the current health care system.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Sample selection process.
Figure 2
Figure 2. Emergency department charges across payer group for the ten most frequent outpatient conditions.
Vertical bars indicate median charge for each of the ten conditions by insurance type: uninsured (black), Medicaid (dark grey), and private insurance (light grey). Medicaid patients were charged the most overall (median $1305), followed by private insurance ($1245), and uninsured patients ($1178).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Tang N, Stein J, Hsia RY, Maselli JH, Gonzales R (2010) Trends and Characteristics of US Emergency Department Visits, 1997–2007. JAMA 304: 664–670. - PMC - PubMed
    1. National Center for Health Statistics (2006) Health: United States, 2006, With Chartbook on Trends in the Health of Americans. Hyattsville, MD: NCHS. - PubMed
    1. Hsia RY, MacIsaac D, Baker L (2008) Decreasing Reimbursements for Outpatient Emergency Department Visits Across Payer Groups From 1996 to 2004. Ann Emerg Med 51: 265–274. - PubMed
    1. Emerman E, Arnoff S (2010) Watson Wyatt Identifies Open Enrollment Benefit Trends for 2010 Watson Wyatt Worldwide. Washington, DC: Warson Wyatt.
    1. Wielawski I (2000) Gouging the Medically Uninsured: A Tale of Two Bills. Health Affairs (Millwood) 19: 180–185. - PubMed

Publication types

LinkOut - more resources

-