The largest healthcare company in the US is sounding the alarm on a new kind of emergency room that charges 20 times more than a regular doctor visit

, up from about 25% in 2010. Those plans require a person to spend thousands out of his or her own pocket before their health insurance starts covering their care.Free-standing emergency departments got a boost in 2009 when Texas passed a law thatThey're staffed by doctors and can do a lot of the diagnostics that a hospital-connected ER can, but they're not equipped to do all of it. Car crashes, strokes and other more serious illnesses and injuries still get transferred to the hospital.

The model takes a lot of education, too. Martin said that Signature Care make it clear when patients call that the center is for emergency care and acts just as an emergency room with emergency room-level prices. , insurers are required to pay for emergency care for their members, even if the place they get their care is out of network, keeping many of the free-standing emergency rooms in service.Dr. Sabrina Poon, an emergency-medicine doctor at Vanderbilt University, has been looking into the different ways patients decide to get care, such as at urgent care centers and free-standing emergency departments.

For the most part, the scope of visitors didn't change at the three sites, and a lot of folks came in for the same conditions they would have if they were going to an urgent care center. But the centers were raking in a lot more money.

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