How much does a Level 4 emergency room visit cost?

Filed Under: Costs, Patients, Providers

alexian brothers bill v2

What does a Level 4 emergency room visit cost?

The community member shared details of two emergency room visits on the same day, one for $2,168 and one for $2,938.

Intrigued, I asked:

“1. We see two shares from you, for two emergency room visits on the same day. Can you tell us about the circumstances?
“2. Do you have an explanation of benefits or bill you could share with us? Please feel free to black out any identifying details.
“3. What did your insurer pay, and what were you asked to pay?
“P.S. How did you find us?”

He replied:

“When I requested a copy of my detailed invoice, I shows charges for two (2) ER visits AND one (1) for the ICU, all for the same visit. Turns out that even though the detailed statement SHOWS both a Level 4 ($2,168.00) and Level 5 ($2,938.00) ER visit, I was only truly billed for the Level 5.

“It was determined at initial check in (11:45pm on 5/16/2022) that I was a Level 4, however full examination from the Head Doctor on staff, I was moved up to a Level 5. I was having an Anaphylactic reaction that was causing my tongue to swell, almost to the point of having to be intubated.

“The EPI I was given started to work and after 4 hours of observation in the ER, I was moved to the ICU/Critical Care ($5,637) at 4am on 5/17/2022 in the event the EPI stopped working and I needed emergency assistance that the ER felt they wouldn’t be able to provide. I was released at 11am in the morning on the 17th, after spending about 12 hours total at the facility.

“Total amount I was charged for my visit was $16,386.00 (which did not include the Level 4).

“Insurance ‘Adjustment’ was $10,751.41, Cigna Paid $2,871.73 and I paid $2,762.86 as I had a deductible I had still had to pay.

“I’ve included both the detail of costs charged by Alexian Brothers as well as my Insurance’s explanation of benefits. I redacted all the personal information other than my first name.

“I found your website after doing a search online for what a ‘level 4’ charge description was while trying to figure out heads and tails of the detail I was sent.

“Feel free to pull what additional information you can post on your website as I hope it’s beneficial to others, but please keep my personal information protected.

“Let me know if I can provide any additional information :)”

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Part 3: Appealing a denial, or how to turn a “no” into a “yes.”

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