If patients have to figure out if they're walking into an urgent care center or an emergency room, well, that's another level of work. Most people naturally think of an ER as in a hospital.

Zhang owed $1,000 to Parkland — a $500 emergency room copay for each of his two visits. What gives: Parkland's Urgent Care Emergency Center is what's called a freestanding emergency department.

Shady Grove's emergency department has three times the volume of the national average for a hospital of its size (281 beds), and last year, there were 85,600 visits.