Virginia Woman Charged $400 Before Receiving Life-Saving Injection at Urgent Care

Stephanie Rowell, a 53-year-old manager from Round Hill, Virginia, was asked to pay $400 for an epinephrine injection before receiving the medication at a TruHealthNow urgent care center in July. Rowell was experiencing anaphylaxis, a severe allergic reaction to a wasp sting, and her father was driving her to the nearest emergency room when they stopped at the Purcellville facility.

Rowell described immediate symptoms including a burning arm, full-body itching, and facial swelling. She took Benadryl before arriving at the clinic. A nurse practitioner diagnosed anaphylaxis and advised that she needed a shot of epinephrine to reverse the reaction. A medical assistant then informed Rowell that she must pay $400 up front for the medication.

"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."

Rowell returned to the waiting area to retrieve her debit card from her father. The staff administered the shot after she paid. She reported that her throat began to loosen within minutes of the injection. The total bill was $605, which included the $400 medication cost, a $40 administration fee, and a $165 visit charge.

Preet Takhar, CEO of TruHealthNow, told KFF Health News that the company's emergency policy is to provide treatment before handling billing. However, Takhar and Manbir Takhar, the medical director and Preet Takhar's wife, confirmed that Rowell was asked for payment while the injection was being prepared. Manbir Takhar stated that the request did not delay the shot because the patient was stable.

Federal law requires hospital emergency departments to stabilize patients regardless of their ability to pay. Urgent care centers are generally exempt from this requirement unless they are owned by hospitals, according to Barry Furrow, director of the health law program at Drexel University. The Urgent Care Association reported that more than 15,000 urgent care centers handled approximately 185 million patient visits in 2025.

Alan Ayers, an urgent care industry consultant, noted that while collecting copays at check-in is standard for outpatient medicine, it should not apply to patients with anaphylaxis. Arthur Caplan, professor emeritus at the New York University Grossman School of Medicine, said doctors have an ethical obligation to treat emergency patients without requiring up-front payment if they have the capability to do so.

Rowell said she was not upset about the final price but felt the timing of the payment was incorrect. The generic cost of an EpiPen is about $175, according to GoodRx. She now carries an EpiPen at home. Her daughter posted a summary of the incident on a Facebook community page, which received hundreds of comments.

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