Average Medicaid Emergency Room Visit Payments in Toa Baja, PR: $44.17
Avg. Paid
$44.17
Range
$0.00 – $73.19
Total Claims
8,269
Providers
13
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 Toa Baja, PR
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Nildaliz Andrews
N19 Calle 14 |
$33.89 | 3,044 | 2,764 |
|
William Soto Aviles
611 Calle Ezequiel # G-27 |
$73.19 | 2,022 | 1,606 |
|
Fermin Hernandez
8064 Paseo Las Gaviotas Urb. Camino Del Mar |
$48.70 | 1,553 | 1,149 |
|
Nestor M Baez
Ap8 Calle 15 |
$14.85 | 640 | 570 |
|
Ronald Isaac Ortiz Almanzar
Reparto Anamar #14 Digitalis |
$36.98 | 353 | 298 |
|
Billy J Rosado Rivera
Levittown |
$48.38 | 244 | 137 |
|
Nabil Salah Aldin
Carr.863 Km.0.6 |
$0.00 | 135 | 129 |
|
David Rafael Perez Pantoja
Fp39 Calle Mariano Brau |
$8.81 | 80 | 80 |
|
Metro Toa Baja, Inc.
Ave Sabana Seca Int 867 |
$23.56 | 70 | 68 |
|
Luis A Paris Rivera
Hf16 Calle Lizzie Graham |
$8.62 | 58 | 51 |
|
Cesar G. Gerena Candal
Calle Lizzie Graham Jr-5 |
$23.45 | 44 | 44 |
|
Jorge Cedeno Espaillat
610 Ave. Comerio Final |
$5.42 | 13 | 13 |
|
Melissa Ozema Baez
Ap8 Calle 15 |
$9.00 | 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 Toa Baja, PR?
Based on public Medicaid payment data, the average Medicaid reimbursement for Emergency Room Visit in Toa Baja, PR is $44.17 per claim, based on 8,269 claims from 13 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 Toa Baja, PR?
There are 13 Medicaid providers offering Emergency Room Visit related services in Toa Baja, PR according to public payment data.
What is the price range for Emergency Room Visit in Toa Baja, PR?
Medicaid reimbursement for Emergency Room Visit in Toa Baja, PR ranges from $0.00 to $73.19 per claim, with an average of $44.17. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Emergency Room Visit in Other Cities
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Avg $110.55
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Chicago, IL
Avg $84.83
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Phoenix, AZ
Avg $203.26
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Indianapolis, IN
Avg $116.65
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New York, NY
Avg $130.02
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Columbus, OH
Avg $98.63
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Brooklyn, NY
Avg $130.10
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Philadelphia, PA
Avg $135.52
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Other Procedures in Toa Baja, PR
Blood Work & Lab Tests
Avg $9.31
326,030 claims
Office Visit
Avg $3.02
201,766 claims
Dental Cleaning & Exam
Avg $21.01
78,156 claims
Urinalysis & Urine Tests
Avg $3.17
72,774 claims
Durable Medical Equipment (DME)
Avg $34.40
68,403 claims
Vaccines & Immunizations
Avg $4.91
28,018 claims
Psychiatric Evaluation
Avg $2.39
25,537 claims
Speech Therapy
Avg $47.52
19,784 claims