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Urgent Care Clinic vs. Hospital Emergency Room – Costs & Comparison

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A few years ago, our cat bit my husband while he was trying to give her a pill. He made the mistake of not seeing a doctor right away, and by the time his hand started to swell up, the doctor’s office was closed for the weekend. We knew it couldn’t wait until Monday, so we went to the emergency room, where it took us nearly five hours just to see a doctor and get a prescription for an antibiotic – which we then had to find an all-night pharmacy to fill. And on top of everything else, we had to pay a $100 copay to our insurance.

This trip to the ER was a big pain, but at the time, we figured we had no choice. In fact, we could have saved ourselves a lot of hassle by going to an urgent care center instead.

Urgent care centers are health care facilities that treat urgent but non-life-threatening problems. They don’t have as much equipment as a hospital ER, and they can’t admit you for long-term care if you need it. But for the problems they can treat, their service is usually much faster, and much cheaper. This makes them a great choice if you need affordable care without health insurance – or if you just have better things to do than spend half the night waiting to see a doctor.

Urgent Care Centers vs. Hospital Emergency Rooms

Normally, when you have a health problem, you go to see your doctor. However, this isn’t always possible if you have an urgent problem that needs treatment right away, such as my husband’s cat bite. Most doctor’s offices are heavily booked, and they usually can’t give you a same-day appointment, even for an emergency. And on evenings and weekends, 73% of Americans say they have no access to their primary care doctors at all, according to Debt.org.

Urgent care centers were created in the 1990s to fill in this gap. Like emergency rooms, they’re open every day, and you don’t need an appointment to get care there. However, there are several major differences between an urgent care center and an ER, including:

  • Facilities. Urgent care centers don’t have the elaborate medical equipment you’ll find in a hospital emergency room. However, they do have basics like X-ray machines, EKGs, and equipment for lab testing. With this gear, they can handle simple jobs like giving a shot or testing a blood sample, as well as more complex tasks like setting a broken bone.
  • Drug Dispensing. Unlike many ERs, urgent care centers in most states keep a stock of drugs on-site to dispense to patients. They usually have basic medications like antibiotics, antiviral drugs to reduce the spread of the flu, and pain medication for short-term conditions, such as back pain.
  • Staff. Urgent care centers don’t have access to the variety of medical specialists you’ll find in a hospital. Instead, they’re staffed mainly by family physicians or urgent care specialists. Most of them also employ medical assistants, nurses, or both.
  • Hours. Emergency rooms are open all day, every day. Urgent care centers are usually open seven days a week, but only until around 8pm or 9pm.
  • Triage. Emergency rooms sort patients when they arrive based on how urgent their problems are – a process known as triage. The patients with the most dangerous conditions are seen first. At urgent care centers, patients are seen in the order they arrive.
  • Payment. Hospital ERs must treat everyone, even if they can’t afford to pay. Urgent care centers, by contrast, require payment – either up front or through insurance – at the time of your visit.

Hospital Emergency Rooms

Benefits of Urgent Care Centers

According to a 2016 report from the Centers for Disease Control and Prevention (CDC), nearly one in five Americans visits a hospital ER each year. However, not all of them really need to. About 19% of all emergency room patients say they only went there because their doctor’s office was closed or because they had nowhere else to go for care.

These patients would probably be much better off receiving care from an urgent care center. They could get the care they need faster and at a much lower cost. They’d also face less risk of having their health insurance companies refuse to cover the cost.

Lower Costs

The reason so many people use the emergency room for non-emergency care is that, by law, hospital ERs aren’t allowed to turn patients away – whether they can pay or not. As a result, many people who don’t have health insurance rely on the ER as their main source of health care. To make up for all these nonpaying patients, ERs charge higher rates to everyone else.

This makes the emergency room one of the most expensive place to get care. According to the health insurer Cigna, the average visit to a hospital ER costs $1,757. By contrast, the average visit to an urgent care center costs $153.

Here are some estimates from Medica, a health insurance company, of how the cost of treating specific illnesses in the ER compares to the cost of treating them in urgent care:

  • Allergies: $733 in ER, $200 in urgent care
  • Bronchitis: $1,074 in ER, $242 in urgent care
  • Earache: $779 in ER, $229 in urgent care
  • Pinkeye: $621 in ER, $184 in urgent care
  • Strep Throat: $1,043 in ER, $231 in urgent care
  • Urinary Tract Infection: $1,264 in ER, $247 in urgent care

Faster Service

Emergency rooms are in the business of saving lives. To save as many people as possible, they always make a point of treating patients with life-threatening illnesses first. Anyone who goes there with a condition that isn’t life-threatening – like my husband with his bitten hand – can expect to wait a long time.

On top of that, many hospital ERs are severely overcrowded. That means even once you’re let into an examining room, you’re likely to spend a lot of time waiting to receive the care you need. A 2014 CDC report found that the average ER patient spends 30 minutes in the waiting room and over 90 minutes receiving treatment. Thus, if you go to the ER with a problem, you can expect to be there for more than two hours.

Urgent care centers, by contrast, see patients on a first-come, first-serve basis. The Urgent Care Association of America (UCAOA) reports that at most urgent care centers, the average wait time to receive care is less than 30 minutes. The total time most patients spend there, from start to finish, is under an hour.

Access to Medicine

Many hospital emergency rooms can’t dispense drugs on-site. An ER doctor can give you a prescription, but you have to go to a pharmacy to get it filled. As my husband discovered, that can be a big problem if you don’t get out of the ER until after 1am.

Urgent care centers, by contrast, can usually dispense drugs right on-site. If you walk in with an infection that requires antibiotics, you can walk out with a supply of them, instead of a prescription to have filled somewhere else.

Insurance Coverage

Because emergency room care is so expensive, health insurers would rather see their patients get care anywhere else. Often, they refuse to cover the cost of an ER visit if it wasn’t a true emergency. If you go to the ER with a non-urgent problem like a sore throat or a sprained ankle, there’s a good chance your insurance plan will refuse to pay for the visit, sticking you with a bill for hundreds or even thousands of dollars.

Fortunately, these are the kinds of cases that urgent care centers can handle easily. If you take your sprained ankle to an urgent care center instead of the ER, your insurer will probably pay for the visit. Dr. Franz Ritucci, President of the American Academy of Urgent Care Medicine (AAUCM), says in an interview with Debt.org that about 70% of all visitors to urgent care centers use health insurance and have no cost but a copay. However, it’s still a good idea to call the urgent care center before you go and make sure it accepts your insurance.

Even if your insurer does cover the cost of an ER visit, you could still save money by going to an urgent care center. Insurers tend to charge extra-high copays for emergency room care – often $100 or more. By contrast, the copay for a trip to an urgent care center is likely to be a more reasonable $35 to $75.

Drawbacks of Urgent Care Centers

Although urgent care centers are both faster and cheaper than the ER, they aren’t the best choice in every situation. Here are a few of the downsides of choosing an urgent care center rather than a hospital emergency room:

  • Limited Services. Urgent care centers are good at treating problems that can’t wait until your doctor’s office is open. However, they’re not equipped to deal with true, life-threatening emergencies. Patients who have symptoms of a heart attack or stroke, severe burns, or trouble breathing need the life-saving care a hospital ER can provide.
  • Limited Hours. Most urgent care centers are open seven days a week until 8pm or 9pm. However, they can’t provide 24/7 care like an ER. If you get into a car accident at midnight, you’ll probably have to go to an ER – even if your injuries are minor.
  • No Payment Plans. Most patients who visit urgent care centers have insurance to cover the cost. However, if you don’t, you’ll probably have to pay for your visit in full before you leave. Unlike ERs, most urgent care centers do not offer payment plans.

Urgent Care Centers Drawbacks

When to Choose an Urgent Care Center

When you’re deciding where to go for medical care, there are two questions you should ask yourself. The first is, “Can it wait?” A trip to an urgent care center costs less than going to the ER, but more than seeing your regular doctor. If you have a medical problem that isn’t urgent – say, a minor sore throat or a backache – it’s better to wait for a doctor appointment.

The second question is, “Is it deadly?” Urgent care centers are cheaper and faster than emergency rooms, but they can’t handle life-threatening emergencies. If you have a problem that could kill you if it’s not treated right away, you need to head for the nearest ER. There, you’ll be moved straight to the front of the line, and you’ll also be able to get the care you need to stabilize you.

If the answer to both questions is no, that’s when an urgent care center – assuming there’s one that’s open – is your best choice. You’ll get in and out faster than you will at the ER, and you’ll probably pay less too, with or without insurance.

Problems That Can Be Treated in Urgent Care

Here are some examples of urgent, but not deadly, problems that can be treated in an urgent care center:

  • Pain. When you’re in serious pain, you don’t want to wait until your doctor can give you an appointment. Urgent care centers can treat problems like severe headaches, back and joint pain, and abdominal pain.
  • Infection. If you have any kind of infection, it’s important to deal with it right away. It may not be dangerous now, but it could be if it’s not treated. An urgent care center can treat animal and insect bites, eye and ear infections, skin rashes and infections, and urinary tract infections.
  • Minor Illness. Like infections, some illnesses aren’t an immediate threat, but they can become much more serious if they aren’t treated right away. These include fever, flu, severe sore throat and cough, vomiting or diarrhea that could lead to dehydration, and mild to moderate asthma.
  • Minor Injuries. Urgent care centers can treat sprains, strains and most broken bones. They are equipped with X-ray machines to show when a bone is broken. They can also treat wounds that require stitches but aren’t bleeding heavily. An urgent care center is a good place to be checked out after a fall or other minor accident to find out whether you have any serious problems, such as a concussion.

Problems That Require an Emergency Room Visit

Even if you know you should go to the emergency room for life-threatening problems, it’s not always easy to tell when your problem is life-threatening. Health insurers tend to rely on what they call the Prudent Layperson Standard.

According to this rule, if a “prudent layperson” – that is, a reasonable person who has no medical training – would believe that your health problem could be serious enough to threaten your life, or to cause permanent organ damage, then you should go to the ER. Even if the doctors there eventually conclude that your problem is something less serious, your insurance should still cover the cost of the visit.

Here are some examples of conditions that call for emergency medical care:

  • Symptoms of a heart attack, including chest pain or pressure lasting longer than two minutes, and difficulty breathing
  • Symptoms of a stroke, including sudden numbness or weakness, lost or blurry vision, disorientation, and difficulty speaking
  • Severe wounds, including deep knife wounds, gunshot wounds, or any wound with heavy, uncontrolled bleeding
  • Severe burns
  • Severe injuries to the head, neck, back, or eyes
  • Compound fractures, in which the bone is protruding through the skin
  • Severe allergic reactions, asthma attacks, or anything else causing labored breathing
  • Poisoning or drug overdose
  • Severe abdominal pain, repeated vomiting, or coughing or vomiting blood
  • High fever, especially in young children
  • Complications during pregnancy, such as vaginal bleeding
  • Convulsions, seizures, paralysis, or loss of consciousness

How to Find an Urgent Care Center

According to the UCAOA, there are nearly 7,400 urgent care centers in the United States. You can find them in stand-alone buildings, in strip malls and shopping centers, or attached to medical offices.

Many urgent care centers are part of large, nationwide chains. The biggest ones include:

One way to find an urgent care center near you is to search the websites of these large chains. You can also try the search tool on the AAUCM website, which lets you search by state or zip code. Another searchable site is UrgentCareLocations.com, where you can look for urgent care centers as well as other types of health care providers. This site can provide directions to a selected center and even sort the list to show you which sites are open.

One feature these search tools don’t include is information about which types of health insurance a given center accepts. The best way to find this information is to search the website of your health insurance provider. Some companies have search tools that let you locate nearby health care facilities that accept your plan. If yours doesn’t have this kind of tool, your best bet is to call nearby urgent care centers and ask them if they take your insurance.

Find Urgent Care Center

Final Word

It’s easy to see how choosing an urgent care center over an ER can benefit you. However, what might be less obvious is how it can benefit others. The truth is, when you choose to visit an urgent care center instead of an emergency room for non-emergency care, you’re also helping the health care system as a whole.

One of the many factors contributing to the rising cost of healthcare in this country is the number of people who rely on hospital emergency rooms as their main source of care. When people switch from ERs to less expensive urgent care centers, it helps lower the amount health insurers have to shell out for their care. This, in turn, reduces the amount the insurers have to charge for premiums in order to make a profit.

A 2010 study by the RAND Corporation found that if all non-emergency visits to ERs could be shifted to urgent care centers and retail clinics, it could save the country over $4 billion a year. Of course, that’s only a drop in the bucket compared to the $3 trillion the U.S. spends each year on health care costs – but it’s one small step towards fixing a big problem.

Have you ever visited an urgent care center? If so, would you recommend it?

Amy Livingston
Amy Livingston is a freelance writer who can actually answer yes to the question, "And from that you make a living?" She has written about personal finance and shopping strategies for a variety of publications, including ConsumerSearch.com, ShopSmart.com, and the Dollar Stretcher newsletter. She also maintains a personal blog, Ecofrugal Living, on ways to save money and live green at the same time.

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