Urgent Care Visit Cost: Insurance vs. No Insurance
Due to lower costs and convenience, urgent care centers and stand-alone health clinics are becoming more popular. As of 2019, across the United States, there were around 9,616 urgent care centers. But what do they treat at an urgent care clinic? How much does it cost compared to going to the ER? What if you don’t have insurance? We’ll cover these questions and more, plus offer cost-saving advice.
What is Urgent Care?
Healthcare.gov defines urgent care as “Care for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe it requires emergency room care.”
In other words, it’s the middle ground between assessing bug bites and performing surgery. Urgent care centers provide relief without the wait or expense of going to your hospital’s emergency department.
Urgent Care Visit vs. Emergency Room Visit
Hospital emergency rooms are usually busier and always more expensive than urgent care centers. The cost of an ER visit varies, but the average cost is around $1,200. So when you can’t see your primary care physician or normal health care provider, a trip to urgent care is usually the most cost-friendly move.
Typical urgent care services include minor medical treatments that you can get at the doctor’s office such as:
- Physicals
- Sprains
- Urinary tract infections
- Vaccines
- Flu shots
- Upper respiratory infections
- Earache
- Sore throat
- Strep throat
- Bronchitis
- STD treatment and diagnosis
When should you go to the ER?
- Chest pain and other signs of a heart attack
- Problems breathing
- Weakness or numbness on one side
- Confusion
- Slurred speech
- Fainting
- Serious burns
- Head injury
- Eye injury
- Broken bones
- Dislocated joints
Types of Procedures Offered at Urgent Care Facilities
Besides physical exams, urgent care may provide the following procedures:
- X-rays
- Minor surgical procedures (stitches, mole removal, cauterization, incision and drainage, cyst extraction, fingernail or toenail removal)
- Pap smear testing
- STD testing
- Pregnancy tests
- Blood tests (complete blood count, metabolic panels, enzymes, cholesterol, triglyceride)
- Flu tests and COVID-19 tests
Interested in learning more about procedure costs? Use this price comparison tool to quickly access the costs of these procedures (and lots of others) from providers in your area.
How Much Does a Trip to Urgent Care Cost if You Have Insurance?
All ACA-compliant health insurance plans cover emergency care, though not all insurers define what emergency care is in the same way. So, most insurance plans cover urgent care, and your out-of-pocket costs will likely be cheaper than an ER visit.
Most insurance plan providers encourage the use of urgent care clinics during off-hours, weekends, and holidays — when you can’t see your regular doctor — by charging fees and copays similar to an office visit with a primary care provider. However, some plan providers, like TRICARE, only allow you to visit urgent care clinics that are within your network up to two times each year without prior authorization.
The typical copay for urgent care is between $25 and $50. Your insurance company sets the rates, and they may vary.
The average out-of-pocket costs for an urgent care visit if you have insurance breaks down like this:
Copay and/or coinsurance + deductible (if applicable) = out-of-pocket costs
To find out exactly how much you will have to pay, consult your health insurance plan policy’s explanation of benefits (EOB).
How Much Does Urgent Care Cost for Uninsured Patients?
In the United States, 5.4 million laid-off workers became uninsured between February and May 2020, an increase that is 39% higher than any other in modern history.
The average cost of an urgent care visit is $100 to $200, according to American Family Care, the largest urgent care clinic in the United States.
Depending on your medical needs, this could be much higher. Procedures like lab tests and X-rays will increase the amount of your final bill.
Urgent Care Alternatives
Many people go to the ER for simple medical care when they are between paychecks or have a high deductible insurance plan, because an emergency department (unlike urgent care) is obligated to provide care to all patients regardless of their ability to pay.
If you fall into this category or have no insurance, the following urgent care alternatives may fit your needs:
- Free clinics: Many communities offer free or low-cost health care clinics. The cost of using these clinics usually depends on your income or ability to pay. State and local health departments also offer deeply discounted services similar to urgent care clinics. Additionally, there are around 1,400 charity hospitals and clinics across the United States.
- Retail health clinics: Chains like CVS and Walgreens, as well as big-box stores like Target and Walmart, offer minor medical care via retail health clinics (RHC). RHCs offer walk-in health care services in select stores across the United States. The average cost for treatment at an RHC is around $100.
- Telehealth: This is one of the most budget-friendly ways to access health care today. According to UnitedHealthcare, the average cost for telehealth, currently around $50, is about 50% less than most urgent care visit costs. You don’t need to have insurance to use telehealth either. CVS offers telehealth visits via the Minute Clinic.
How to Save on Your Urgent Care Visit Cost
If you are covered by insurance, make certain to go to an urgent care clinic that accepts your specific insurance plan. Calling your provider is the best way to avoid the unhappy surprise of unmet urgent care costs.
If you’re wondering how you can save money on your out-of-pocket costs, you have a few options. For one, many urgent care clinics offer discounted rates of up to 20% off when you pay in cash. And you can always visit Aunt Bertha, the website that connects you with partners in your area. Their mission is to provide community support, including financial help for medical bills, prescriptions, copays, and deductibles.
Sometimes when you have to go to an urgent care center, you don’t have time to worry about the costs of tests and procedures. But when possible, looking up prices on Compare.com puts you in control of your health care, helping you make better, more informed decisions.
Disclaimer: Compare.com does not offer medical advice and is in no way a substitute for any medical advice received from health professionals. Compare.com is unable to offer any advice on any medical procedure you may need.
