kind of charge when their patients are seen in that ER. When those contracts are made, then that ER group is considered “in network”. Each insurer pays a different amount for the same exact charge, depending on those negotiations.

When no agreement is made, which often happens, then that ER group is considered “out of network.” When that happens, then all bets are off and the billing and who pays what gets even more convoluted. I don’t know what happened in your case, as I am not privy to the status of CIGNA with that ER group, but I agree with the other poster who said that it’s likely considered out of network, making things a mess. It’s even messier in the ER, because by law they cannot turn you away based on insurance, so you don’t really know to avoid the mess. It’s also messy because a provider could be out of network while a hospital is in network.

This is why we should just go single payer.

What you should do is call the billing dept for that ER group.