Price Checker / CPT 99281
How much does ER visit — minor (level 1) cost?
CPT 99281 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 44x the fair price — among the most extreme markups. Dispute this.
Fair price
$15–$35
What this should cost
With insurance
~$59,700
Typical out-of-pocket
Overcharged if over
$45
Push back above this
The average hospital charge of $1,109 is $1,084 over the fair price (about 44x the fair rate).
What hospitals charge for ER visit — minor (level 1)
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Phelps Hospital SLEEPY HOLLOW, NY | — | $1,839 | 41606% |
| Grundy County Memorial Hospital GRUNDY CENTER, IA | $3,624 | — | 32786% |
| BRIGHAM CITY COMMUNITY HOSPITAL BRIGHAM CITY, UT | — | — | 32704% |
| CACHE VALLEY HOSPITAL NORTH LOGAN, UT | — | — | 32704% |
| LAKEVIEW HOSPITAL BOUNTIFUL, UT | — | — | 32704% |
| MOUNTAIN VIEW HOSPITAL PAYSON, UT | — | — | 32704% |
| OGDEN REGIONAL MEDICAL CENTER OGDEN, UT | — | — | 32704% |
| PLEASANT VIEW EMERGENCY CENTER , UT | — | — | 32704% |
| "ST MARK'S HOSPITAL" SALT LAKE CITY, UT | — | — | 32704% |
| TAYLORSVILLE EMERGENCY CENTER , UT | — | — | 32704% |
| WEST VALLEY EMERGENCY , UT | — | — | 32704% |
| South Shore University Hospital , NY | — | $1,839 | 28149% |
| "Cohen Children's Medical Center" , NY | — | $1,839 | 27795% |
| Lenox Hill Hospital NEW YORK, NY | — | $1,839 | 27795% |
| Long Island Jewish Forest Hills , NY | — | $1,839 | 27795% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About ER visit — minor (level 1)
CPT code 99281 refers to er visit — minor (level 1) (billing description: "Emr dpt vst mayx req phy/qhp"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $11 in a facility (hospital or surgery center) and $11 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.