ER visit cost-sharing in N/R: what patients actually pay
From 80,661 real out-of-network emergency items in federal surprise-billing dispute files (2025), here is what patients in N/R were charged in cost-sharing, by ER visit code:
Visit code
Cases
25th pct
Median
75th pct
90th pct
99281
68
$44
$200
$302
$322
99282
648
$60
$151
$331
$566
99283
17,213
$89
$171
$429
$740
99284
43,992
$48
$150
$253
$586
99285
18,740
$60
$170
$318
$793
Nationally, patient cost-share for the same ER code in the same city varies up to 52x — and a federal appeals court ruled in August 2026 that the benchmark it is computed from was being calculated unlawfully. If your number is above the 75th percentile here, dispute it in writing.
Your rights on an emergency bill
Under the No Surprises Act you owe only in-network cost-sharing for emergency care, even at an out-of-network ER.
Balance bills for protected emergency services are generally prohibited.
Ask in writing for the itemized bill and how your cost-share was calculated, including the qualifying payment amount.
Fighting a denial or a surprise bill? Medigami turns these public records into your specific next step — appeal winnability, benchmarked bills, and generated letters. medigami.com