Local 2 Investigates looks at pricing between urgent cares, free-standing ERs

Houston leads nation in number of state-licensed emergency care facilities

HOUSTON – Houston is leading the nation in terms of the number of state-licensed emergency care facilities. One woman loved the service and the fact that her son was seen immediately at one, but when she got the bill, she was stunned.

At just 7-years-old, Gavin Grajales never stops moving -- that is until something stops him.

"He was on the monkey bars and he fell off, and fractured his wrist and his elbow at the same time," said Holly Grajales, Gavin's mother.

When Gavin injured himself, his mother first took him home not realizing how serious it was, but later she decided to take him to her nearby neighborhood urgent care center, where she expected to pay $300 to $400.

What Grajales did not realize is that she had actually taken her son to one of those new, free-standing emergency rooms that are popping up all over Houston.

In fact, Houston is leading the nation in terms of the number of state-licensed emergency care facilities.

Of the 90 free standing ER centers now in Texas, Houston has 54 and many more on the way.

"We got right in, no waiting. They X-rayed him, gave him some pain medication and they splinted his arm," said Grajales.

Grajales loved the service and the fact that her son was seen immediately, but when she got the bill, she was stunned.

"It was sticker-shock. I don't even know how to describe it, but I received a bill for almost $2,000," said Grajales.

"It's one of the terrible surprises we have in health care and we hear of these surprises too many times," said Vivian Ho with the James A. Baker III Institute Chair in Health Economics at Rice University.

Ho said it's hard for consumers to tell the difference between urgent-care centers and free-standing ER centers because they look alike and are usually located in the same places -- in strip malls next to places like Starbucks.

But Ho said the price difference between the two can be shockingly different.

"You could be paying under $200 at an urgent care center, and that very same care could easily cost over $1,000 at an emergency care center," said Ho.

With help from a hospital billing expert and former hospital administrator at seven different hospitals, Local 2 Investigates looked into the price range you could pay without any insurance for three common problems at an urgent care center and at a free-standing ER.

Local 2 Investigates found for a routine broken bone not sticking through the skin, the price at an urgent care would cost between $180-$200. The same injury at a stand-alone ER would range between $1,200-$2,000.

For a respiratory illness like pneumonia or bronchitis, the cost would range from $155-$200 at an urgent care. The same thing at a free-standing ER would range between $600-$2,000.

A urinary tract infection or a suspected STD would range from $155-$200 at an urgent care, while it could cost between $500-$1,500 at a free-standing ER.

"The primary difference between an urgent care and a free-standing ER is an ER is licensed and regulated by the state of Texas. Urgent cares are not. They are physician's offices with extended hours and there is no licensure," said Rhonda Sandel, CEO of Texas Emergency Care Center.

Sandel said free-standing ERs have to have a board certified emergency room doctor on duty 24 hours a day, seven days a week, and urgent cares do not.

She said free-standing ERs are also required to have much more heavy-duty medical equipment on site, and have to be able to handle much more serious injuries than urgent care centers.

"We handle everything from gunshot wounds to stabbing victims, heart attacks, strokes, car accidents," Sandel said.

So how can you tell if you are walking into an urgent-care center or a free standing ER? It's simple.

If you see the word "emergency" anywhere on the building, it's a free-standing ER. Urgent-care centers are forbidden by law from using the word "emergency" in any of their signage.

Experts said remember in a true emergency, you need an emergency room.

"If you have crushing chest pain, neurological problems, are having a stroke or have suffered severe trauma like a stab wound, gunshot or punctured eyes, you need to go to an ER," said Dr. Juliet Breeze, CEO of Next Level Urgent Care.

But for less serious health issues, Breeze said, "An urgent-care center can save you hundreds of dollars."

Health experts said if you're not sure where to go, talk to your family doctor before your next health issue pops up.