Not every trip to the urgent care clinic is planned in advance, for obvious reasons. Depending on what ails you in the moment, you might not consider what your visit will cost or how you’ll pay for it.
Here’s what to know about paying for urgent care, and how prices compare to seeing your primary care doctor or going to the emergency room.
What is the average cost of an urgent care visit?
Urgent care costs depend on a few things. It will cost less if you don’t require many diagnostic tests, but visits are pricier if you need X-rays, lab work or a procedure like stitches, splinting or casting. Taking all these variables into consideration, the average urgent care visit is about $175 with insurance, according to Lou Ellen Horwitz, CEO of the Urgent Care Association.
“If you don’t have insurance or are paying cash and not billing your insurance, the urgent care will be able to provide immediate pricing for you so you can make informed decisions with your provider about what tests or treatments you want done,” she says. “With insurance-paid visits, the urgent care team may need to do a little research to get an exact cost.”
How does the cost of and urgent care visit compare to a PCP visit or an ER visit?
There is no set guideline for private practices, but in most cases, urgent care costs are comparable to the cost of a visit to your primary care physician. As with urgent care, a PCP will charge extra for additional services and tests. Unlike urgent care, you will need to make an appointment.
Going to the emergency room, however, can be very expensive, adding up to nine times as costly as urgent care for the same services, says Horwitz. The average cost of an emergency room visit in 2018 was $1,010. (This doesn’t include the price of an ambulance if one is necessary.) Tests, X-rays and MRIs all cost more than they would elsewhere.
Emergency rooms are very expensive to run for a variety of reasons. They require lots of specialized, often very expensive medical equipment, as well as a specially trained staff and efficient support staff. They are also open 24/7 and must see anyone who walks through their doors.
Are any urgent care centers “in network” for insurance?
Yes, typically all urgent care centers are considered in network. An exception might be something like a highly regionalized plan that would restrict visits to any provider outside the region.
When an urgent care center (or any other type of healthcare facility) is in network, your insurance provider has pre-negotiated rates for healthcare with that practitioner, business or system. These rates are often lower than their normal fees, making it cheaper for you and your insurance provider.
How much is the copay for urgent care?
Copays are typically a bit more expensive at urgent care than getting an appointment at a primary care office, but at least a hundred dollars lower than the ER.
“It’s usually very easy to tell what your copay is to an urgent care,” says Horwitz. “Just flip over your insurance card. Most of them list urgent care alongside primary care and the ER with copays.”