DALLAS (CBSDFW.COM) – They may look like urgent care centers, but they’re not. More and more freestanding E.R.s are being built in suburban neighborhoods across North Texas. They’re just like they sound — complete emergency rooms not attached to any hospital. The services you can get there come with an emergency room price.

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Juliette Coulter found that out the hard way. In January Coulter was fighting what felt like the flu. In a hurry, she bypassed her regular physician and visited Highland Park Emergency Center in Dallas. Doctors gave her a breathing treatment, x-rays, flu swab and prescriptions, all in about 45 minutes. Coulter says that was great, but then when the bill came, she really felt sick. The facility had charged Coulter nearly $2500 for treating acute bronchitis. “This is highway robbery,” says Coulter, “I don’t want other people to be deceived by these places.”

Coulter is not alone. Since stand-alone ERs are a relatively new business, many don’t realize they often come with a much higher price tag than your primary care doctor or even an urgent care facility. For example, on Coulter’s bill, she was charged more than $1,000 simply because Highland Park Emergency Center is a full-service emergency department. Devon Herrick, a health economist for the National Center for Policy Analysis says that’s common. He says since freestanding ERs come with the same equipment and ability of hospitals, you’ll be paying for it. Consumers should only use them for truly serious or life threatening conditions. “I guess maybe a good rule of thumb is, is there any risk of death? If I’m not likely to die,” says Herrick, “It may not be really an emergency. It may be just urgent care I need.”

While freestanding ERs are for serious conditions, urgent care centers are typically for minor emergencies like sprains, stitches, cuts and coughs. That would have probably been a better choice for Coulter, who was fighting bronchitis. In addition to stand-alone ERs and urgent care centers, there are also retail clinics inside some major chain stores. Experts say they’re usually staffed by nurse practitioners or physician assistants and will typically treat things like strep throat, infections, and minor injuries.

We contacted Highland Park Emergency Center about this story and they told us patients are warned about the possibility of a higher bill from their facility. In fact, they told us, “Patients signing in to be treated at our ER are all asked to sign a consent to treatment form. This form clearly states in the first line of the first paragraph in bold underlined print that we are not an urgent care center.” Highland Park Emergency Center also claims patients are told this verbally as well. Coulter called Highland Park Emergency Center and eventually got her bill reduced.

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How can you protect yourself? Before you get any service, ask upfront what it will cost. If you see “ER” anywhere in the name of the facility, expect to pay to more. Perhaps the best advice is to have a plan of where you’ll go for care before you ever get sick.

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