The extraordinary thing about this study is it conflates "charges" with "costs". In the US of course what the opatient is/should be worried about is the outrageous charges they will incur for a UTI diagnosis and treatment. It costs nothing like $2000 to treat and manage a simple UTI. In Australia where I practice as an ED physician we have calculated the actual opportunity cost of a simple visit like this as being about $50-100 (that includes, lights, personnel time, dipstick urine etc e.g. additional costs to actually having an ED open) . On top of this would be faciltiy costs of about $50-100 as the cost of running/ building/ maintaining your facility which has to be there and open 24/7 anyway. Obviously if you are for profit as in US probably a mark up of 25% on costs would be reasonable- so it would cost 250-300$ even in a private system to treat a simple UTI. How on earth a UTI could cost $2000 to treat suggests outrageous overcharging, over servicing or possibly simple UTI patients are subsidising the care of sicker more complex patients. Whatever the reason charges described here bear no realtionship to the actual costs of delivering this sort of care.