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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
Lauderdale Lakes, FL $54.22 $5.82 – $70.23 34,234 16
San Marcos, TX $110.21 $53.62 – $170.61 34,254 16
Uniontown, OH $71.21 $27.32 – $124.68 34,311 11
Petersburg, WV $189.42 $45.75 – $303.34 34,356 10
Hancock, MI $121.34 $25.67 – $182.67 34,454 5
Palestine, TX $125.08 $25.66 – $411.71 34,492 14
Vernon, CT $233.48 $39.06 – $364.66 34,522 8
New Castle, IN $91.28 $31.03 – $118.21 34,555 7
Tooele, UT $42.26 $20.66 – $100.91 34,558 4
Alice, TX $163.10 $41.04 – $204.35 34,597 6
Saint Peters, MO $135.54 $43.88 – $407.34 34,682 32
Oneida, TN $118.66 $0.00 – $161.45 34,862 8
Batesville, MS $138.84 $18.95 – $148.95 34,865 6
Pitkin, LA $124.13 $124.13 – $124.13 34,903 1
Pennington Gap, VA $182.42 $61.88 – $509.39 35,011 5
Plainview, NY $139.18 $33.49 – $182.49 35,022 16
Rockport, TX $109.11 $45.39 – $870.52 35,082 8
Darby, PA $132.75 $13.79 – $296.63 35,095 16
Crystal River, FL $66.77 $10.72 – $79.06 35,113 15
Porterville, CA $47.90 $0.00 – $99.56 35,114 19
Noblesville, IN $98.81 $35.54 – $226.65 35,122 18
Norwood, MA $103.84 $39.75 – $196.73 35,132 22
Auburn, CA $65.98 $0.44 – $850.19 35,231 13
Homer, LA $131.69 $50.05 – $159.86 35,235 9
Port Saint Lucie, FL $80.80 $4.13 – $111.73 35,284 17
Ferriday, LA $98.53 $11.75 – $125.34 35,324 7
Menomonie, WI $142.47 $17.52 – $259.04 35,352 11
Conroe, TX $111.44 $24.81 – $843.11 35,397 30
Sharon, CT $122.47 $30.08 – $190.39 35,421 8
Christiansted, St. Croix, VI $68.86 $68.86 – $68.86 35,469 1
West Liberty, KY $227.67 $40.45 – $262.60 35,475 4
Waverly, OH $98.62 $40.84 – $122.74 35,478 5
Watervliet, MI $158.34 $158.34 – $158.34 35,478 1
Wauseon, OH $97.13 $44.69 – $125.01 35,511 5
Oak Grove, LA $59.71 $49.84 – $86.44 35,587 8
Jefferson Hills, PA $93.15 $0.00 – $117.61 35,728 15
Lewiston, NY $152.16 $48.76 – $152.51 35,761 3
Pullman, WA $225.15 $34.87 – $249.91 35,804 8
Ketchikan, AK $329.83 $0.00 – $418.45 35,813 13
Natchitoches, LA $95.37 $45.50 – $141.12 35,838 21
Rockingham, VA $75.50 $36.10 – $323.10 35,874 18
Abbeville, LA $116.87 $48.91 – $157.26 35,875 7
Cedar Falls, IA $133.64 $37.75 – $214.78 35,946 10
Truckee, CA $78.23 $35.90 – $132.27 35,993 17
Shelbyville, IN $57.70 $7.06 – $92.93 36,000 17
Blairsville, GA $144.35 $53.44 – $173.47 36,009 12
Canton, TX $104.40 $48.34 – $154.39 36,012 18
Midwest City, OK $150.39 $60.07 – $177.22 36,036 12
Washington, PA $96.94 $5.53 – $203.43 36,050 17
Aberdeen, SD $78.36 $21.51 – $128.58 36,050 13

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.