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Based on public Medicaid payment data.

Average Medicaid Emergency Room Visit Payments

Typical Medicaid Emergency Room Visit reimbursement across 7,184 cities

Avg. Medicaid Paid

$119.20

Price Range

$0.00 – $985.41

Total Claims

450.3M

Cities

7184

Typical Payment Range

Typical Medicaid Emergency Room Visit payments fall between $56.00 and $114.21 per claim (median: $78.41). The top 10% of payments exceed $164.43.

Based on per-provider averages across all Medicaid claims in this category.

About This Procedure

Emergency department visits for urgent and emergency medical care. Costs vary significantly based on severity level and treatments needed.

Why do these costs look low?

These figures represent Medicaid reimbursement rates β€” the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.

Costs by City

City Avg. Paid Min / Max Claims Providers
Detroit, MI $110.55 $6.82 – $522.41 4,694,783 272
Chicago, IL $84.83 $0.00 – $3,312 4,391,753 1550
Phoenix, AZ $203.26 $0.00 – $1,044 4,304,161 851
Indianapolis, IN $116.65 $0.00 – $299.48 4,172,341 898
New York, NY $130.02 $0.00 – $607.31 3,905,512 1591
Columbus, OH $98.63 $0.00 – $1,887 3,813,295 929
Brooklyn, NY $130.10 $0.00 – $421.32 3,752,387 1080
Philadelphia, PA $135.52 $0.00 – $935.78 3,661,931 1481
Cleveland, OH $98.94 $6.16 – $348.89 3,436,346 878
Milwaukee, WI $64.11 $9.68 – $338.96 3,433,334 694
Bronx, NY $138.65 $0.00 – $971.50 3,278,500 846
Los Angeles, CA $84.68 $0.00 – $568.48 3,238,140 1029
Louisville, KY $161.52 $0.00 – $530.61 2,991,678 505
Baton Rouge, LA $116.89 $0.00 – $771.41 2,376,685 514
Houston, TX $183.70 $0.00 – $3,136 2,360,699 1404
Washington, DC $153.94 $0.00 – $493.21 2,354,612 687
Cincinnati, OH $94.36 $5.74 – $719.78 2,312,527 649
Boston, MA $120.95 $0.00 – $923.97 2,297,423 1146
Charlotte, NC $128.07 $0.07 – $1,106 2,244,542 692
Tucson, AZ $160.21 $0.00 – $377.45 2,175,628 489
New Orleans, LA $128.91 $6.77 – $878.14 2,136,041 532
Lexington, KY $156.12 $2.21 – $436.55 2,128,548 494
Richmond, VA $137.78 $12.69 – $240.07 2,065,177 375
Las Vegas, NV $89.64 $0.00 – $368.64 2,035,127 798
San Diego, CA $104.48 $0.00 – $528.82 1,987,395 726
Dallas, TX $145.88 $0.00 – $1,531 1,942,869 853
Orlando, FL $85.72 $0.00 – $686.18 1,940,642 694
Baltimore, MD $96.82 $-13.31 – $395.00 1,908,492 1013
Grand Rapids, MI $106.82 $19.64 – $587.93 1,903,454 76
Nashville, TN $115.01 $0.00 – $1,001 1,887,270 731
Toledo, OH $93.09 $14.43 – $247.63 1,886,372 319
Memphis, TN $119.96 $0.00 – $954.94 1,856,841 465
Akron, OH $101.47 $0.00 – $412.20 1,830,030 396
San Antonio, TX $126.61 $0.00 – $1,112 1,783,972 691
Albuquerque, NM $154.16 $0.52 – $431.19 1,757,889 555
Sacramento, CA $137.25 $0.00 – $1,045 1,743,927 571
Dayton, OH $97.08 $10.95 – $277.79 1,743,160 360
Bakersfield, CA $198.12 $0.00 – $463.19 1,742,847 242
Atlanta, GA $261.11 $0.00 – $538.83 1,736,171 660
Aurora, CO $123.06 $4.40 – $669.12 1,707,782 663
Portland, OR $158.80 $0.00 – $2,230 1,692,627 553
Hartford, CT $216.04 $0.64 – $1,025 1,622,100 330
Jackson, MS $109.91 $6.03 – $294.37 1,613,802 313
Seattle, WA $91.01 $6.86 – $329.92 1,579,665 551
Miami, FL $96.60 $0.00 – $653.31 1,553,357 810
Riverside, CA $105.30 $0.05 – $287.58 1,531,635 181
Fort Worth, TX $219.10 $0.00 – $1,986 1,524,539 489
Oklahoma City, OK $141.78 $0.00 – $544.76 1,523,446 412
Saint Louis, MO $128.84 $0.00 – $1,498 1,505,298 965
New Haven, CT $223.61 $4.69 – $605.48 1,483,537 424

Cost Components

National averages for each billing code in this procedure category. Sorted by claim volume.

Code Description Avg. Paid Claims Providers
99284 ER visit high severity $118.05 170,705,529 95,397
99283 ER visit moderate severity $106.85 157,926,994 92,923
99285 ER visit high sev w/threat $136.01 111,002,396 79,755
99282 ER visit low severity $104.38 24,203,945 35,900
99291 Critical care first 30-74 min $120.48 10,902,745 28,076
99281 ER visit minor problem $92.67 8,018,086 9,327
99292 Critical care each addl 30 min $72.51 273,485 1,267

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.