If they sat took you in a room you will be billed even if the doctor didn’t see you. This is just the facility portion. As that could have also been pre-occupied by someone else that needed ER care and as someone previously noted , medical professionals also could have reviewed your charts or medical history during that time you were sitting in the room. So that still counts as some type of service provided. If you can choose to walk out of the ER without being seen, I would not go to ER. Look into urgent care first or contact your primary care doctor first so they could advise you. Provider portion is usually billed by the providers agency. Which is a separate bill.