Unfortunately that’s probably a fair market price for an ER visit depending on where he lives. By law providers are not allowed to charge different prices for services so what happens is the retail price for healthcare is dramatically higher than what the provider expects in return from the insurance companies. For example, if your buddy had good health insurance, his actual financial responsibility would have been much less. Just one of the many ways our healthcare system is broken.

However as some have mentioned already, many hospitals/clinics realize that uninsured patients will end up with the largest bill and many of them will have a patient financial assistance or advocacy department to help patients negotiate down their bill based on their ability to pay - sometimes at significant discounts. I would definitely ask your buddy to reach out to the hospital.

I am a physician and I always thought I had good insurance until I went into the ER for a kidney stone (the same hospital I worked at) and received a bill for over $2k after - turns out I had a high deductible plan.