doctor office visit cost without insurance

How Much Does a Doctor Visit Cost With and Without Insurance?

Without insurance, medical care can get pricy fast. Where you live, what doctor you’re going to, and what tests you need will all figure into your doctor’s visit bill. In this article, we’ll break down those costs and give you some tips for saving money.

What Goes into the Cost of a Doctor’s Visit?

Geography is one of the biggest factors in the price of a doctor’s visit. Most medical facilities pass some of their overhead expenses onto their patients. If you live somewhere with a higher cost of living, like California or New York City, you’ll likely pay more for doctors’ visits. The practice has to pay more for utilities and rent, and those costs show up in your bill. For example, Mayo Clinic’s Patient Estimates tool quotes $846 for a 60-minute office visit in Jacksonville, Florida, but $605 for the same visit in Wisconsin.

Like the cost of living, supplies and equipment will also end up on your tab. Say you need a strep test, blood draw, or Pap smear. The supplies needed for the test plus the cost of the lab fees will all figure into the price.

Bills for the same exams and procedures can also vary depending on what kind of facility you’re going to. Smaller practices and public health centers are often a lot cheaper than university or private hospital systems. This is due in part to their buildings being smaller and their overhead fees being lower.

Price of Out-of-Pocket Doctors’ Visits

The cost of a doctor’s office visit also depends on what kind of doctor and the procedure you need to have done. For example, an in-office general wellness checkup will be cheaper than a specialist procedure. If you have an emergency, an urgent care center will be much more affordable than the emergency room.

Primary Care Physician — Physical Exam

Physicals usually include blood pressure readings, cholesterol measurements, and vaccines. Prostate exams for men and Pap smears and breast exams for women are also often included. Pediatric physicals focus on the growth milestones for your child’s age. Doctors check height, weight, sleep patterns, diet, and the vaccines required by public schools.

The range for a yearly physical can be anywhere from $100 to $250 or more without insurance. A CVS Minutecare Clinic may charge just $59 for a sports physical, but not all organizations will accept this as proof of physical health.

Primary Care Physician — Procedures

On top of the base cost for physical exams, you may have extra charges for any specific tests or procedures you need. According to the Cardiometabolic Health blog, the most common procedures in primary care medicine include bloodwork, electrocardiograms, and vaccines/injections.

Bloodwork is one of the biggest cost wild cards. Certain tests can run you from as little as $10 to as much as $10,000 . Large national labs like Labcorp offer pricing on their website, so you know what to expect going in. For example, Labcorp’s General Health Blood Test , which includes a metabolic panel, complete blood count (CBC), and urinalysis, costs $78.

Electrocardiograms or EKGs check your heart health and can find cardi ac issues. This quick procedure involves monitoring your heartbeat through electrodes placed on your skin. While it’s a painless and accurate way to detect heart conditions, the costs can add up without insurance. Expect to pay as little as $410 or as much as $1700 for this procedure, depending on local prices.

Vaccines are often required before sending your kids to school. The CDC publishes a vaccination price list annually to give you an idea of what to expect. For example, they quote $19-$132 for DTaP, $21 for Hepatitis A, and $13-$65 for Hepatitis B. The COVID-19 vaccine, however, is free of cost, regardless of insurance status.

Urgent Care Visit

If you have an emergency but are stable, urgent care is much cheaper than the emergency room. According to Scripps , most urgent care centers and walk-in clinics can at least treat dehydration, cuts or simple fractures, fever, flu, strep, and UTIs. Note that if you have chest pain, a serious injury, seizures, a stroke, or pregnancy complications, you should go straight to the ER .

For a base exam at an urgent care facility, expect to pay between $100-$150 . That price will go up depending on what else you need. For example, Advanced Urgent Care in Denver quotes $80 for an X-Ray, $50 for an EKG, $135 for stitches, and $5 for a urinalysis. In comparison, expect to pay $1,000-$1,300 for the same procedures in the emergency room.

How to Lower Your Out-of-Pocket Medical Costs

Healthcare expenses may seem overwhelming without insurance. Luckily, there are many resources available to help you cover the costs.

Free & Low-Cost Immunization and Wellness Clinics

For standard vaccines and checkups, look for local free or low-cost clinics. Check out The National Association of Free and Charitable Clinics’ search tool to find a location near you. Your city’s public health department should also offer free or low-cost vaccines and basic medical care services.

Certain large vaccine manufacturers also offer vaccine programs. For example, Merck’s patient assistance program offers 37 vaccines and medicines free to eligible patients. The program includes albuterol inhalers and vaccines for Hepatitis A, Hepatitis B, MMR, and HPV.

Cash Negotiations

Most health systems offer lower rates for patients paying cash. Some even have free programs for low-income families. For example, Heritage UPC in North Carolina has a yearly membership for low-cost preventative care. In Northern California, the Sutter Health medical system offers full coverage for patients earning 400% or less of the Federal Poverty Income Guideline .

As of January 1, 2021, all hospitals in the United States now have to follow the Hospital Price Transparency Rule . That means they have to list procedure prices clearly on their website. You can also call medical billing before your appointment to discuss cash pay options.

Federal Medical Payment Support

If all else fails, there are federal programs to help you cover the cost of medical bills.

Organizations like The United Way and United for Alice offer grants for ALICE (asset-limited, income-constrained, employed) patients. These are people living above the poverty level, making them ineligible for other government programs but below the basic cost-of-living threshold.

Medicaid is available for children, pregnant women, and adults under a certain income threshold. If your income is too high to qualify for Medicaid but you can’t afford private insurance for your children, you may be eligible for the Children’s Health Insurance Program (CHIP) to cover your children’s medical care.

Use Compare.com for the Best Doctors’ Visit Prices

Navigating bills for a doctor’s visit can feel overwhelming, but Compare.com is here to help. With our price comparison tool, you can search all clinic and doctors’ office prices in your area. Compare makes sure you’re prepared for the cost of your checkup long before you schedule your appointment.

Nick Versaw leads Compare.com's editorial department, where he and his team specialize in crafting helpful, easy-to-understand content about car insurance and other related topics. With nearly a decade of experience writing and editing insurance and personal finance articles, his work has helped readers discover substantial savings on necessary expenses, including insurance, transportation, health care, and more.

As an award-winning writer, Nick has seen his work published in countless renowned publications, such as the Washington Post, Los Angeles Times, and U.S. News & World Report. He graduated with Latin honors from Virginia Commonwealth University, where he earned his Bachelor's Degree in Digital Journalism.

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How Much Does a Doctor’s Visit Cost Without Insurance?

According to the Agency for Healthcare Research and Quality, the average cost of a visit to the doctor’s office in 2016 was $265, with expenses ranging from $159 to $419 depending on the specialty.

• At an urgent care center you can expect to pay between $100-200 to see a provider, plus the cost of any treatments or testing you may need.
• Always ask for pricing information before you agree to any testing or treatment. You are entitled to this information.

Going to the doctor for any reason can be expensive. Without insurance, you can expect to pay approximately anywhere from $50–$350 just for a routine medical exam, which doesn’t include additional expenses such as x-rays , blood tests, or other lab work.

The cost of a doctor's visit

According to Solv’s Chief Medical Officer, Dr. Rob Rohatsch, the cost of a doctor’s visit can vary widely depending on factors such as:

• The type of doctor you are seeing
• The reason for your visit
• Where you see the doctor, for example, if you go to an urgent care facility or a doctor’s office
• Whether you are a new or established patient
• Any necessary tests or treatments
• Whether you need lab work

Visits to specialists such as primary care providers, pediatricians, and psychiatrists were lower than the average cost, while the most expensive doctor’s visits were for orthopedists and cardiologists.

Data from the Agency for Healthcare Research and Quality indicates that if you are visiting a doctor and don’t have insurance, you can expect to pay roughly the following amounts. The cost could vary depending on the factors listed above.

• Psychiatry: $159
• Pediatrics: $169
• Primary care: $186
• Dermatology: $268
• OB/GYN: $280
• Ophthalmology: $307
• Cardiology: $335
• All other: $365
• Orthopedics: $419

Additionally, if you are a new patient, there may be an additional charge associated with your new patient exam.

Where to see a doctor without insurance

If you don’t have insurance, the cost of your doctor’s visit can also be affected by where you go to see the doctor. There are many places you can seek medical care, some of which are more affordable than others, notes the Agency for Healthcare Research and Quality:

• Community health clinics often provide free medical care or low-cost care, including preventive care, health screenings, and vaccinations .
• Urgent care centers offer many health services. Many don’t require appointments, although your wait time may be less if you schedule an appointment in advance. You can expect to pay around $100 - $200 to see an urgent care provider, plus the cost of any treatments or testing you may need.
• Many health care facilities now offer telehealth services, which are often more convenient and more affordable. For some conditions, however, you may need to be seen in person for proper diagnosis and treatment.
• If your medical need is not urgent, and you know the type of doctor you need to see, you can schedule an appointment with a primary care physician or a specialist at their office. Be sure to ask about their payment policy in advance. If you don’t have insurance, you may be required to pay the entire bill at the time of service.
• If you have a medical emergency, you can visit the nearest emergency room. Even if you don’t have insurance, you will be able to receive treatment. However, this is typically the most expensive option. If you have a non-emergency medical condition that can wait until you can be seen at one of the other options, you will likely save money.

Paying self-pay prices for doctor’s visits

Even if you have insurance, you may be able to save money by paying cash for certain medical services. While preventive care may be covered at 100% by your insurance company, other tests and treatments may be applied to your deductible. If you have a high deductible and don’t expect to meet it – especially if it’s late in the calendar year – paying cash for your medical care may be a cheaper option.

Most doctor’s offices and health care providers charge a higher price when they bill the insurance company. For example, they may charge the insurance company $70 for a treatment or service, but if the patient is paying cash, they may only charge $60. This is known as the self-pay price . If you pay cash, the claim won’t be submitted to your insurance company, but you could end up saving money.

Always ask for pricing information before you agree to any testing or treatment. You are entitled to this information. As of 2021, hospitals are required to disclose self-pay prices, even when the patient has insurance. If the doctor’s office won’t provide you with this information, be persistent, or seek care somewhere else. If you plan on paying self-care prices, you aren’t limited to the providers in your insurance network. You’ll have a wider range of options to choose from, and you can choose a provider who is willing to provide fair, clear prices.

Let your doctor’s office know that you are paying out of pocket, and ask if they offer a discount for self-pay patients. Many doctor’s offices will offer special rates for patients who are paying cash or who do not have insurance; however, they may not advertise these rates, so it’s always a good idea to ask.

Know what you’ll pay ahead of time with Solv ClearPrice TM

According to Healthcare Finance News, more than half of Americans avoid going to the doctor when they’re sick due to high medical costs or unclear costs. Solv is committed to eliminating surprise medical bills with Solv ClearPrice™ . We partner with thousands of providers across the country who have agreed to display self-pay prices for their services. When you book an appointment on Solv, you will be able to see the self-pay price for many common services.

To schedule an appointment, search our directory for a provider in your area. Begin typing the service you are looking for, and choose from the list of options that appear. If you aren’t sure which type of doctor you need to see, you may want to try an urgent care clinic or a walk-in clinic . In many cases, you can schedule an appointment quickly and conveniently online, and many of our providers have same-day or next-day appointments available.

Frequently asked questions

What factors affect the cost of a doctor's visit, what is the average cost of a visit to the doctor’s office, are there any additional charges for new patients, where can i seek medical care if i don't have insurance, what is the self-pay price, are hospitals required to disclose self-pay prices, can i get a discount if i'm paying out of pocket, what is solv clearprice™.

Michael is an experienced healthcare marketer, husband and father of three. He has worked alongside healthcare leaders at Johns Hopkins, Cleveland Clinic, St. Luke's, Baylor Scott and White, HCA, and many more, and currently leads strategic growth at Solv.

Dr. Rob Rohatsch leverages his vast experience in ambulatory medicine, on-demand healthcare, and consumerism to spearhead strategic initiatives. With expertise in operations, revenue cycle management, and clinical practices, he also contributes his knowledge to the academic world, having served in the US Air Force and earned an MD from Jefferson Medical College. Presently, he is part of the faculty at the University of Tennessee's Haslam School of Business, teaching in the Executive MBA Program, and holds positions on various boards, including chairing The TJ Lobraico Foundation.

Solv has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

• Agency for Healthcare Research and Quality: Expenses for Office-Based Physician Visits by Specialty and Insurance Type, 2016 https://meps.ahrq.gov/data_files/publications/st517/stat517.shtml
• Hospital Price Transparency, Centers for Medicare and Medicaid (2022) https://www.cms.gov/hospital-price-transparency
• More than half of Americans have avoided medical care due to cost (2019) https://www.healthcarefinancenews.com/news/more-half-americans-have-avoided-medical-care-due-cost
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No Insurance? How to See a Doctor Without Insurance

Shop around, ask about cash discounts and consider community health centers and free clinics.

This article is based on reporting that features expert sources.

8 Tips for Getting Medical Care Without Insurance

Millions of people in the U.S. live without health insurance, a circumstance that can cause people to weigh the need to see a doctor against the cost. Unfortunately, many people will put off or do without medical care because they can't afford it, a decision that could jeopardize their health.

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While the Affordable Care Act has boosted the number of Americans with insurance, millions remain uninsured. In 2018, 27.5 million people – more than 8% of the U.S. population – were uninsured, according to the U.S. Census Bureau. Private health insurance covered 67% of Americans. Those without health coverage face the dilemma: Where can I go for medical care without insurance?

The Coverage Gap

In addition to the people who are uninsured, millions are underinsured, according to a survey by the Commonwealth Fund. Among people with health insurance, 29% were underinsured in 2018, compared to 23% in 2014, according to the fund's Biennial Health Insurance Survey: "People who are 'underinsured' have high health plan deductibles and out-of-pocket medical expenses relative to their income and are more likely to struggle paying medical bills or to skip care because of cost."

The survey found that 41% of underinsured adults reported they delayed needed medical care because of cost. By contrast, 23% of people with adequate insurance coverage said they delayed such treatment. Also, 47% of underinsured adults reported medical bill and debt problems.

Tips for Finding Affordable Medical Care

If you're uninsured or underinsured, here are eight strategies for finding affordable medical care:

• Research your eligibility for insurance.
• Shop around.
• Agree to a price in writing.
• Ask about a cash discount.
• Keep good records.
• Be prepared.
• Consider community health clinics.
• Think about urgent care centers.

1. Research your eligibility for insurance.

Depending on your situation, you might be eligible to buy individual health insurance coverage from the ACA marketplace or in the individual market, or you might qualify for Medicaid, Medicare or the Children's Health Insurance Program for your kids, says Kim Buckey, vice president of client services at DirectPath, a company that provides personalized health benefits education and enrollment services to large employers.

2. Shop around.

Prices for health care appointments and procedures vary dramatically, with differences of up to 2,000%, says Bill Kampine, co-founder and senior vice president, analytics and innovation, for Healthcare Bluebook. The company's client base includes municipal and large self-insured employers. It also offers a free online tool that individuals can use to comparison shop for health care services by region.

3. Agree to a price in writing.

4. Ask about a cash discount.

5. Keep good records.

6. Be prepared.

7. Consider community health centers and free clinics.

There are a number of health care providers that provide services at little or no cost to those who are eligible, says April Temple, an associate professor of health sciences at James Madison University in Harrisonburg, Virginia.

8. Also, think about urgent care centers.

Nationwide, there's been a meteoric rise in the use of urgent care centers in recent years. These facilities provide a higher level of care than what's available at some pharmacy retail clinics, but aren't equipped to provide emergent care for things like heart attacks and strokes. Urgent care centers can treat a wide array of maladies, including upper respiratory infections, bronchitis, diverticulitis; high blood pressure, food poisoning, sprains, minor fractures and lacerations. An urgent care visit typically costs around $150, according to Debt.org.

12 Common Medical Emergencies

The U.S. News Health team delivers accurate information about health, nutrition and fitness, as well as in-depth medical condition guides. All of our stories rely on multiple, independent sources and experts in the field, such as medical doctors and licensed nutritionists. To learn more about how we keep our content accurate and trustworthy, read our  editorial guidelines .

Buckey is vice president of client services at DirectPath, a company that provides personalized health benefits education and enrollment services to large employers.

Kampine is co-founder and senior vice president, analytics and innovation, for Healthcare Bluebook. The company’s client base includes municipal and large self-insured employers. It also offers a free online tool that individuals can use to comparison shop for health care services by region.

Temple is an associate professor of health sciences at James Madison University in Harrisonburg, Virginia.

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Primary Care Visits Available to Most Uninsured But at a High Price

‘secret shopper’ study finds cost of basic new patient visit without health insurance far more than most uninsured can afford.

Uninsured people don’t have any more difficulty getting appointments with primary care doctors than those with insurance, but they get them at prices that are likely unaffordable to a typical uninsured person, according to new Johns Hopkins Bloomberg School of Public Health-led research.

And payment options are not very flexible, with only one in five people told they could be seen without paying the whole cost up front, suggests the new study published in the May issue of the journal Health Affairs .

“There’s a discouragement factor for uninsured people when it comes to seeing a doctor when they are sick,” says study leader Brendan Saloner, PhD, an assistant professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. “If you pick up the phone and the cost is high, you may stop looking – even if you are really sick. For a lot of people, it’s bewildering to navigate the primary care market without health insurance.”

Saloner’s research is based on data from a 10-state telephone survey in which callers posed as patients from November 2012 to March 2013 to find out whether they could get a new patient appointment with a primary care doctor and, if so, how much a basic visit would cost. Callers only revealed their uninsured status after being offered an appointment. The audit, which included 1,613 completed calls, was conducted before the implementation of the Affordable Care Act in late 2013, which not only has given more patients private insurance but also has increased the number of people with Medicaid in many states.

While there are fewer uninsured people now and the number is expected to drop again in 2015, Saloner says, there is still a sizable uninsured population in the United States, particularly those who live in states that have not expanded Medicaid and who still believe that coverage on the ACA marketplace is unaffordable.

In total, roughly 79 percent of uninsured callers in the study were offered an appointment, while only about 6 percent who were denied an appointment were told that the denial was due to insurance status (other reasons included that the practice wasn’t taking new patients). The average price of a new uninsured patient appointment was quoted as $160, with some variation among states (a low of $128 in Pennsylvania and a high of $188 in Oregon). The price was significantly lower at federally qualified health centers ($109). Prices were also lower for offices in ZIP codes with higher poverty rates. The price was for a basic new patient appointment, and the callers did not request price quotes for any additional blood work, imaging or other testing.

Still, Saloner points out, a medical bill of $100 would represent about one-tenth of the monthly income of a single adult living at the poverty level.

The average price quoted to callers in the study was lower than actual total amounts paid for privately insured new patient primary care visits in the same states (an average of $200), as reported in previously reported research. Of those visits, the average out of pocket cost for privately insured patients was $49.

Only 18 percent of uninsured callers were told they could bring less than the full amount to the visit and pay the rest later. On average, those told they could arrange a payment plan were told to bring 61 percent of the cost of the appointment to be seen.

Saloner says expanding Medicaid beyond the 29 states and the District of Columbia that have already done so, would enable more people to afford basic health care.

“Even with improvements coming with implementation of the Affordable Care Act, the system will make an uninsured person really think twice about whether he or she needs to go to the doctor,” Saloner says.

“ Most Uninsured Adults Could Schedule Primary Care Visits Before the ACA, But Average Price Was $160 ” was written by Brendan Saloner, Daniel Polsky, Genevieve M. Kenney, Katherine Hempstead and Karin V. Rhodes. Collaborators are based at the University of Pennsylvania, the Robert Wood Johnson Foundation and the Urban Institute.

The study was supported by the Robert Wood Johnson Foundation.

Media contacts for the Johns Hopkins Bloomberg School of Public Health: Stephanie Desmon at 410-955-7619 or  [email protected]  and  Barbara Benham at 410-614-6029 or  [email protected] .

Cost of doctor visit by state

The following estimated costs are based on cash prices that providers have historically charged on average for doctor visit and will vary depending on where the service is done. The prices do not include the anesthesia, imaging, and other doctor visit fees that normally accompany doctor visit.

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What happens at a doctor's visit?

People go to the doctor for routine physical exams as well as acute care when they get sick or injured. Visits to the doctor are important for preventing disease and managing any health problems. During your doctor’s visit, the physician checks your blood pressure, temperature, and heart rate. 

Your doctor may listen to your heart, check your ears, nose, and mouth, and perform a physical exam. They may also ask you about your medical history and the medications you take. Your doctor may want you to have blood drawn for laboratory testing during your doctor’s visit.

How long should a doctor’s visit last?

It’s common for your entire visit to the doctor to take a long time. From start to finish, your appointment may take well over an hour . Many patients sit in the waiting room before being called back for examination.

How long you’ll wait depends on your specific doctor’s office and how busy they are. Once you’re in the exam room, the visit with your doctor will go quickly. On average, patients spend about 20 minutes in the exam room with their doctor.

Why are doctor visits so expensive?

Doctor's visits are expensive for several reasons, including their offices’ administrative responsibilities and the cost of medical services. Your doctor’s office has to work with different insurance companies and pay administrative staff trained in medical billing. Your doctor charges for their services, lab work, or imaging they run and may charge facility fees as well.

How much does a doctor visit cost without insurance?

Without insurance, your doctor’s visit can cost hundreds of dollars. On average, people in the U.S. pay just under $400 for their annual physical exam at a doctor’s office if they don’t have insurance. These costs include the provider fee for seeing the doctor and costs for any blood work or imaging that’s needed.

What are the signs of a bad doctor?

Know the warning signs of a bad doctor so you can avoid problems and get better medical care. One sign is if your doctor doesn’t listen to you or take your concerns into account during your visit. Another is if your doctor rushes through your appointment, not giving you the time needed to deal with your concerns.

A third warning sign is if your doctor doesn’t explain why certain tests or treatments are needed in a way you can understand.

What should you not tell your doctor?

Your doctor doesn’t need to know every detail about your life to provide proper care. But they do need you to be truthful about your health. You should never lie about the symptoms you’re experiencing or the medications you’re taking. If you aren’t taking medications as prescribed, your doctor needs to know. You don’t need to tell them health details they already know or give them any of your financial information.

Costs vary by specialty

The cost of a doctor visit could vary depending on the specialty. To see the cash prices for a specialist visit, type is a specialty.

* Savings estimate based on a study of more than 1 billion claims comparing self-pay (or cash pay) prices of a frequency-weighted market basket of procedures to insurer-negotiated rates for the same. Claims were collected between July 2017 and July 2019. R.Lawrence Van Horn, Arthur Laffer, Robert L.Metcalf. 2019. The Transformative Potential for Price Transparency in Healthcare: Benefits for Consumers and Providers. Health Management Policy and Innovation, Volume 4, Issue 3.

Sidecar Health offers and administers a variety of plans including ACA compliant and excepted benefit plans. Coverage and plan options may vary or may not be available in all states.

Your actual costs may be higher or lower than these cost estimates. Check with your provider and health plan details to confirm the costs that you may be charged for a service or procedure.You are responsible for costs that are not covered and for getting any pre-authorizations or referrals required by your health plan. Neither payments nor benefits are guaranteed. Provider data, including price data, provided in part by Turquoise Health.

The site is not a substitute for medical or healthcare advice and does not serve as a recommendation for a particular provider or type of medical or healthcare.

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WEATHER ALERT

3 warnings, a watch and an advisory in effect for 21 regions in the area

‘it’s absolutely outrageous’: houston resident charged surprise $400 ‘facility fee’ after doctor visit, kprc 2 investigates ‘facility fees’ and what to look for on your medical bills.

Amy Davis , Investigative Reporter

Andrea Slaydon , Senior Investigative and Special Projects Producer

HOUSTON – Unexpected, unexplained fees are driving up the cost of doctor visits for families across Houston. We are talking hundreds of dollars in charges above your co-pay. They’re called “facility fees,” and patients are told days or weeks after their appointments they have to pay up.

“It’s absolutely outrageous,” said Mindy Easterbrook.

Outrageous new charges that Easterbrook has never been charged when she takes her two children with Type 1 diabetes to see their doctor.

“They see an amazing doctor there. We absolutely love her, but we’re getting charged facility fees now by Texas Children’s Hospital on top of our regular doctor fees that we’re being billed,” said Easterbrook.

One $290 item on her bill is labeled “observation/treatment room.” Another fee of $405 says it’s a “room, staff and supply charge.”

Texas Children’s Hospital told Easterbrook she will incur these fees at every visit with her children’s endocrinologist where her daughter and son check in every 3 months.

“For these facility fees, you don’t get a choice. You can’t opt-out. You don’t know what these fees are going for,” said Maribeth Guarino.

Guarino has studied facility fees as a healthcare advocate for the U.S. Public Interest Research Group Education Fund or “PIRG” for short.

She says facility fees are common at hospitals where patients are billed separately for doctors, specialists and room charges. But in recent years as hospital systems buy up doctor’s offices, they are adding these facility fees to regular doctor bills.

RELATED: What is a facility fee?

When did Hospitals in the Houston area start charging facility fees?

Texas Children’s Hospital told KPRC 2 it began adding the fees to its doctor’s offices that it considers “hospital-based clinics” on November 1, 2023.

“Right now, these outpatient departments that hospitals own are licensed under the same number as the hospital and so that’s how they kind of get away with “it’s a hospital location” even though the location might actually be 2-10 miles away from the actual campus of the hospital,” explains Guarino.

Other viewers have sent us their bills showing their own fees. One viewer’s bill shows a $200 facility fee. In their case Blue Cross Blue Shield paid $74 leaving the patient owing $126 above their co-pay.

While the chatter is largely from Texas Children’s patients locally, other hospitals here and across the country are charging the same type of fees.

Methodist, Memorial Hermann and MD Anderson all confirmed with KPRC 2 News that they also charge facility fees to patients visiting doctors outside of their traditional hospitals.

15 states have passed laws limiting the fees in some way but only Connecticut has banned facility fees for non-emergency, outpatient care.

Federal lawmakers are currently working on the ‘Lower Costs, More Transparency’ Act. If passed by both the House and Senate, it would end facility fees outside of traditional hospitals.

Until then patients like Hunter, Skye and their mom don’t have a choice.

“Our kids come first. We have to have them seen,” said Easterbook.

“Patients cannot be on the hook for these charges especially when they’re already struggling to pay and delaying care because they’re afraid of the cost,” said Guarino.

What can I do about facility fees on my medical bill?

So, what can you do about these facility fees? We know that many patients have had those facility fees waived as a one-time courtesy when they called the TCH billing department.

A Texas Children’s spokesperson also told me that telehealth visits and urgent care visits will not incur facility fees.

That federal bill is not before the U.S. Senate where it appears to have bipartisan support. You can reach out to your senator if you want them to ban these fees.

The Texas Hospital Association told KPRC 2 News the fees are necessary. They sent this document that explains that hospitals would have to reduce staff, cut services, and close outpatient clinics if these fees are banned.

KPRC 2 News reached out to several of the larger hospital systems in the Houston area to see if they charge facility fees. Find the full statements below.

Texas Children’s Hospital

Over 70 years ago, Texas Children’s was founded on the guiding principle that every child deserves the highest quality care regardless of their family’s ability to pay. Since then, navigating healthcare has become increasingly complex, but we remain resolute that cost should never stand in the way of our patients receiving the care they deserve. If any of our patients are struggling to either understand their bill or need financial assistance, we have a wonderful team dedicated to assisting them every step of the way. We are fully committed to meeting patient families where they are at and assisting them with any challenges or questions they have.

Why did TCH decide to add the facility fee so that they appear on a patient’s bill after what they believed were regular doctor office visits?

Texas Children’s follows the appropriate guidelines when billing health plans for the services rendered on behalf of a patient. It is important to understand that a patient’s out of pocket expense is determined by the assigned benefits within their individual health plan and not by Texas Children’s.

How can patients know when they will see this fee on their bill before they book an appointment?

Texas Children’s is fully committed to price transparency with our patients and offers a number of ways for them to receive a pre-visit estimate ahead of time.

*It is also important for patients to know that if patients schedule a TeleHealth visit or a visit at a Texas Children’s Pediatrics or Urgent Care location, the visit will not include a facility fee charge as that charge is only applicable in a hospital-based location.

Is there a way for patients who see the same doctor for routine visits (monthly visits, for example) can appeal so that they are not paying the facility fee with each appointment?

The facility fee is applicable to each individual visit in a hospital-based location until a patient meets their insurance deductible, after which the fee for each visit will transition to the co-insurance rate predetermined by the patient’s health insurance plan.

Billing FAQ from TCH

Houston Methodist

Houston Methodist does not charge facility fees at its physician-based clinics. There are a few hospital-based clinics where a facility fee is charged such as the transplant clinic, wound care clinic, radiation oncology clinic and the infusion clinic. Facility fees help hospitals offset the higher cost of providing specialty outpatient services to patients allowing us to provide a higher level of care that is safe and convenient for our community.

Billing FAQ from Houston Methodist

MD Anderson

MD Anderson facilities are hospital-based locations offering multidisciplinary hospital-level care in the outpatient setting, which requires specialized staffing and infrastructure. MD Anderson provides patients with one financial statement, which includes both physician and hospital charges, but these may be processed differently by a patient’s insurance. This information is shared with all new patients and is available online. Patients with questions can contact MD Anderson’s Patient Business Services for clarification.

Memorial Hermann

“Memorial Hermann has approximately 90 hospital outpatient departments across the system. These are not doctor’s offices. They are outpatient departments of the hospital that provide highly specialized services. In outpatient departments with a physician-led care team, the physicians are not employed by Memorial Hermann. In compliance with regulatory requirements, patients are provided notice that they are receiving care in an outpatient hospital department and the physician’s billed services will appear separately from the hospital payment. These hospital payments (also known as “facility fees”) cover all of the other essential aspects of care including nurses, lab technicians, technology and other functions – services for which the hospital would not otherwise be paid. Memorial Hermann does not bill facility fees from any of its primary care clinics.

Offering complex care in an outpatient setting means that care is more affordable and more convenient for patients to access, and these hospital payments enable us to effectively partner with physicians to provide that care. We also know that navigating health care costs is complex, so we offer patients access to resources like our good faith price estimate tool so they can make well-informed decisions about their care.”

Billing FAQ from Memorial Hermann

A weekly newsletter with content from KPRC 2's Amy Davis.

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About the Authors

Passionate consumer advocate, mom of 3, addicted to coffee, hairspray and pastries.

Andrea Slaydon

Award-winning TV producer and content creator. My goal as a journalist is to help people. Faith and family motivate me. Running keeps me sane.

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