Guides / Life changes
You need care tonight and you are paying for it
The same problem can cost $150 or $3,000 depending on which door you walk through.
This is about the routine stuff. If it is chest pain, stroke symptoms, severe bleeding or trouble breathing, stop reading and call 911 or go to the nearest emergency room. Cost is not the question tonight.
Where the money goes
For the same complaint, an emergency room is usually the most expensive place in Montana to be seen, urgent care is in the middle, and a next-morning appointment with a primary care clinic is the least expensive by a wide margin.
That is not because the ER is greedy. It is staffed and equipped to handle anything at any hour, and the facility fee reflects that whether or not you needed it.
What a mid-level ER visit costs before anyone treats you
Billing code 99283 is the facility fee for a moderate emergency department visit. It is the charge for walking in and being seen, before any test, scan or treatment is added.
See the numbers
| Hospital | Price |
|---|---|
| Livingston | $219 |
| Sidney | $323 |
| Clark Fork Valley | $331 |
| Big Horn County | $423 |
| Marcus Daly, Hamilton | $564 |
| Barrett, Dillon | $599 |
| Great Falls Clinic | $761 |
Hospitals' own published files. Full comparison.
Things that genuinely need the ER
Chest pain or pressure. Stroke signs, meaning face drooping, arm weakness or speech trouble. Severe bleeding. Trouble breathing. Head injury with confusion or vomiting. A bad fall in someone elderly. Anything you would describe to a friend as frightening.
The prudent layperson standard means you are protected for going to the ER when a reasonable person would have thought it was an emergency, even if it turns out to be nothing. You are not penalised for being wrong in good faith.
Things urgent care usually handles
Cuts that need stitches. Suspected simple fractures. Fevers, ear infections, sore throats, urinary infections. Sprains. Rashes. Mild asthma flare-ups.
Ask two things when you call: whether they can take an X-ray on site, and what a self-pay visit costs. Both are ordinary questions.
Things that can wait for the morning
Most coughs and colds. A prescription refill. A rash that is not spreading. A sore back with no numbness or weakness. A worry you have been sitting on for two weeks.
If you have a primary care doctor you can reach, calling them first costs nothing and often ends the problem in ten minutes.
What to say at the desk
"I am self-pay. What is the self-pay rate for this visit?"
Say it before you are seen. Self-pay rates are often well below the billed price, and a facility that knows you are paying directly will frequently apply one. Ask for the itemised bill afterward.
If the answer is a number you cannot manage, ask about the hospital's financial assistance policy in the same conversation. It exists whether or not they mention it.
Never let cost stop you in a real emergency
Emergency departments must screen and stabilise you regardless of your ability to pay. A bill is a solvable problem afterward, and charity care and bill review both exist. Going home with a heart attack is not solvable.
Sources
Checked 21 August 2026. Rules and thresholds change, so follow the source before relying on a figure here.
Who publishes this. CoreMed Healthcare is a Montana healthcare membership company. We publish these guides because we think the information should be easy to find, and because our own members need it. They are written to answer your question rather than to sell you a membership: where the right answer is a hospital charity care programme or a different kind of plan, that is what they say. Nothing here is legal, tax or medical advice.
Common questions
Will an ER turn me away if I cannot pay?
No. Emergency departments must screen and stabilise you regardless of ability to pay. Sort out the bill afterward, and read the charity care guide before you pay it.
Is urgent care always cheaper?
Usually for the same complaint, but ask what a self-pay visit costs before you go, and whether imaging is on site. A referral onward to an ER means paying twice.
What does self-pay actually mean?
That you are paying directly rather than through a plan. Saying so up front is what unlocks the self-pay rate, which is often a fraction of the billed amount.
I have a CoreMed membership. Where do I go?
Call your CoreMed clinic first for anything that is not an emergency, including evenings. That is what the membership is for. Emergencies go to the nearest ER.
Related
Hospital charity care in Montana
Most Montana hospitals are legally required to have a programme that can reduce your bill to nothing. Hardly anyone knows to ask.
Getting a price before you are treated
If you are paying cash, you have a legal right to a written price before scheduled care. Most people never ask for it.
Read the itemised bill first
The one-line summary is not a bill. Ask for the itemised version, then check these six things.