Average Medicaid Emergency Room Visit Payments in San Sebastian, PR: $42.24
Avg. Paid
$42.24
Range
$3.61 – $99.21
Total Claims
5,530
Providers
11
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.
Emergency department visits for urgent and emergency medical care. Costs vary significantly based on severity level and treatments needed.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Emergency Room Visit in San Sebastian, PR
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Eduardo E Encarnacion Concepcion
126 Calle Pavia Fernandez |
$42.33 | 4,446 | 3,920 |
|
Luis D. Rivera Rivera
1153 Ave Emerito Estrada Rivera |
$10.12 | 406 | 386 |
|
Johnniel Ortiz Mendez
Villa Rita Calle 2 |
$92.12 | 188 | 124 |
|
Juan Luis Robles Nieves
70 Calle Severo Arana |
$99.21 | 115 | 80 |
|
Zuleika Cardona
Carr.445 Km.3.1 Int |
$63.16 | 110 | 64 |
|
Family Health Group S.S.C.S.P
Ave. Emerito Estrada Rivera |
$8.09 | 76 | 57 |
|
Zaydalee Cardona Rodriguez
Hc 6 Box 17376 |
$36.88 | 56 | 12 |
|
Manuel Jimenez-Espinosa
Calle 111 Km 14.3 Bo. Hato Arriba |
$3.61 | 46 | 43 |
|
Eliz Marie Fuentes Perez
Carr 448 Km 2.0 Int Sect Yeyo Gonzalez Bo Guajataca |
$52.16 | 42 | 21 |
|
Erick G. Nieves Rivera
32 Calle Jesus T Pinero |
$6.56 | 32 | 30 |
|
Juan L Colon Quinones
526 Ave Emerito Estrada |
$25.21 | 13 | 13 |
What to Expect: Emergency Room Visit
Emergency room visits begin with triage, where your condition is assessed to determine urgency. Wait times vary from minutes to hours depending on severity. You'll be seen by an ER physician who may order tests, imaging, or procedures. Costs include the facility fee, physician fee, and any tests or treatments. Most ER visits last 2-6 hours.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| 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 are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Emergency Room Visit cost in San Sebastian, PR?
Based on public Medicaid payment data, the average Medicaid reimbursement for Emergency Room Visit in San Sebastian, PR is $42.24 per claim, based on 5,530 claims from 11 providers. Typical payments fall between $56.00 and $114.21. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Emergency Room Visit in San Sebastian, PR?
There are 11 Medicaid providers offering Emergency Room Visit related services in San Sebastian, PR according to public payment data.
What is the price range for Emergency Room Visit in San Sebastian, PR?
Medicaid reimbursement for Emergency Room Visit in San Sebastian, PR ranges from $3.61 to $99.21 per claim, with an average of $42.24. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Emergency Room Visit in Other Cities
Detroit, MI
Avg $110.55
4,694,783 claims · 272 providers
Chicago, IL
Avg $84.83
4,391,753 claims · 1550 providers
Phoenix, AZ
Avg $203.26
4,304,161 claims · 851 providers
Indianapolis, IN
Avg $116.65
4,172,341 claims · 898 providers
New York, NY
Avg $130.02
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Columbus, OH
Avg $98.63
3,813,295 claims · 929 providers
Brooklyn, NY
Avg $130.10
3,752,387 claims · 1080 providers
Philadelphia, PA
Avg $135.52
3,661,931 claims · 1481 providers
Other Procedures in San Sebastian, PR
Blood Work & Lab Tests
Avg $9.35
256,101 claims
Office Visit
Avg $2.43
192,157 claims
Dental Cleaning & Exam
Avg $21.46
139,000 claims
Physical Therapy
Avg $21.86
52,548 claims
Urinalysis & Urine Tests
Avg $3.41
51,242 claims
Dental Filling
Avg $45.03
37,980 claims
Vaccines & Immunizations
Avg $7.84
35,663 claims
Tooth Extraction
Avg $106.01
30,637 claims