Average Medicaid Emergency Room Visit Payments in Wilkes-Barre, PA: $81.37
Avg. Paid
$81.37
Range
$67.61 – $126.49
Total Claims
14,819
Providers
5
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 Wilkes-Barre, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Nicholas Kelley
575 N River St |
$88.86 | 7,932 | 7,745 |
|
Roman Bish
575 N River Street |
$67.61 | 3,372 | 3,306 |
|
Luke E. Sullivan
1000 East Mountain Blvd. |
$73.52 | 3,181 | 3,096 |
|
Loreen Mane
1000 East Mountain Blvd. |
$109.33 | 187 | 114 |
|
Jignesh Patel
1000 East Mountain Blvd. |
$126.49 | 147 | 83 |
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 Wilkes-Barre, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Emergency Room Visit in Wilkes-Barre, PA is $81.37 per claim, based on 14,819 claims from 5 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 Wilkes-Barre, PA?
There are 5 Medicaid providers offering Emergency Room Visit related services in Wilkes-Barre, PA according to public payment data.
What is the price range for Emergency Room Visit in Wilkes-Barre, PA?
Medicaid reimbursement for Emergency Room Visit in Wilkes-Barre, PA ranges from $67.61 to $126.49 per claim, with an average of $81.37. 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
3,905,512 claims · 1591 providers
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 Wilkes-Barre, PA
Home Health Visit
Avg $237.15
41,813 claims
EKG / ECG (Electrocardiogram)
Avg $6.39
12,010 claims
Blood Work & Lab Tests
Avg $6.18
9,917 claims
X-Ray
Avg $8.42
7,788 claims
Office Visit
Avg $47.07
7,088 claims
CT Scan (Computed Tomography)
Avg $51.42
3,562 claims
Nursing Facility Care
Avg $13.12
1,636 claims
Echocardiogram
Avg $43.86
1,592 claims