Urgent Care Center Bill: $605 for EpiPen Shot

$605. That is the total bill Stephanie Rowell received for an urgent care visit in Purcellville, Virginia, in July. The amount covered $400 for medication, a $40 administration fee, and a $165 visit charge. Rowell was uninsured at the time and was treated for anaphylaxis after a wasp sting.

Rowell, a 53-year-old agritourism manager from Round Hill, Virginia, was on her parents' front porch when the wasp stung her left arm. Her arm burned, her body itched, and her face swelled. She took Benadryl, and her father drove her toward a hospital 25 minutes away. After 10 minutes of driving, they stopped at a TruHealthNow urgent care facility to seek faster help.

Rowell told the clinic that her throat tightened and breathing became difficult. A nurse practitioner diagnosed anaphylaxis and prescribed an epinephrine injection. Rowell said she was asked to disclose her lack of insurance before the treatment. A medical assistant then informed Rowell she must pay $400 for the shot upfront. Rowell returned to the waiting area to get her wallet from her father. She handed over her debit card, and staff administered the injection. Her symptoms eased within minutes.

"I asked, 'If I didn't have the money, would you have just let me die?'" Rowell said. "And they said, sorry, that is their policy."

TruHealthNow operates eight urgent care centers in Northern Virginia and Maryland. Preet Takhar, the company's CEO, told KFF Health News that the standard policy is to treat first and handle billing later. However, officials confirmed Rowell was asked to pay before the shot was given. Manbir Takhar, the medical director, stated the nurse practitioner determined Rowell was stable before the payment request. Takhar said the payment request did not delay the injection. "The patient was stable, and that is why we took the payment then," she said.

Federal law requires hospital emergency departments to stabilize patients regardless of ability to pay. Barry Furrow, director of the health law program at Drexel University, noted that urgent care centers generally fall outside this requirement unless they are hospital-owned. Urgent care centers handle minor conditions like sore throats and sprains, not life-threatening emergencies. More than 15,000 urgent care centers handled 185 million patient visits in 2025, according to the Urgent Care Association.

Alan Ayers, an urgent care industry consultant, said collecting payment for non-emergency care is standard. For anaphylaxis, he said it should never be a factor. Arthur Caplan, a professor emeritus of medical ethics at New York University, stated that doctors have an ethical obligation to treat emergencies without asking for upfront payment. "You don't need to have a patient go fumbling around for a credit or insurance card," Caplan said.

Rowell went home after the visit. Her brother monitored her for complications, and she felt better after several days. Her daughter posted the story on a Facebook community page, which generated hundreds of comments. Rowell said she is not upset about the price, which is higher than the roughly $175 cost of a generic EpiPen, but she believes the payment timing was wrong. She now carries an EpiPen.

Ryan Stanton, president of the American College of Emergency Physicians, advised patients to go to the nearest emergency room or call 911 if they are unsure about the severity of their condition. He also recommended that people with life-threatening allergies keep a prescribed EpiPen on hand.