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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
Canandaigua, NY $149.07 $44.24 – $161.32 36,093 6
Bastrop, LA $135.72 $44.74 – $230.16 36,262 10
Port Jervis, NY $173.75 $38.06 – $221.84 36,281 5
Irvine, CA $77.90 $49.28 – $186.61 36,332 40
New Martinsville, WV $91.37 $36.40 – $138.13 36,344 9
Bath, NY $81.37 $12.38 – $128.07 36,430 3
Natrona Heights, PA $104.14 $11.18 – $125.38 36,435 11
Denison, TX $127.03 $36.08 – $182.54 36,448 17
North Vernon, IN $83.19 $42.75 – $103.14 36,510 5
Houston, MO $135.88 $52.88 – $206.41 36,555 9
Antigo, WI $132.15 $45.78 – $149.16 36,600 7
Bonne Terre, MO $125.39 $39.18 – $138.16 36,607 5
Silvis, IL $107.66 $44.70 – $253.09 36,652 12
Alturas, CA $143.95 $1.23 – $170.32 36,828 3
Harrison, AR $81.80 $0.23 – $193.88 36,834 18
Wooster, OH $95.38 $28.32 – $125.56 36,850 6
Bellefontaine, OH $93.08 $29.87 – $118.18 36,884 8
Atlantis, FL $65.41 $13.67 – $311.96 36,958 33
Raeford, NC $82.29 $60.48 – $107.11 37,005 11
Carlisle, PA $84.19 $60.20 – $189.91 37,020 12
Union City, TN $94.81 $51.82 – $207.02 37,078 9
St. Louis, MO $104.10 $17.85 – $602.90 37,096 27
Price, UT $49.95 $15.79 – $273.47 37,112 13
Watertown, WI $50.83 $14.77 – $51.20 37,122 5
Plymouth, IN $112.19 $78.16 – $208.29 37,147 5
Palos Heights, IL $68.73 $13.52 – $169.68 37,155 24
St Louis Park, MN $169.21 $23.29 – $319.92 37,210 40
Laurel, MD $111.33 $23.41 – $175.96 37,249 21
Kotzebue, AK $125.92 $40.55 – $187.00 37,249 6
Othello, WA $168.89 $40.06 – $214.38 37,289 5
Claremont, NH $119.93 $53.21 – $176.69 37,328 6
Dulles, VA $136.51 $51.99 – $181.56 37,347 4
Dallas, OR $167.40 $155.75 – $214.59 37,363 4
Scottsville, KY $193.50 $36.57 – $235.19 37,374 4
Eaton Rapids, MI $125.98 $125.98 – $125.98 37,374 1
Rice Lake, WI $44.31 $23.94 – $88.33 37,427 10
Eglin Afb, FL $74.60 $14.46 – $136.33 37,773 23
Valdese, NC $104.53 $42.77 – $134.46 37,816 5
Ottumwa, IA $119.19 $6.48 – $1,010 37,857 14
Coshocton, OH $76.34 $43.87 – $134.14 37,979 10
Merrill, WI $115.06 $28.77 – $152.39 38,044 4
Concord, CA $66.08 $0.00 – $146.81 38,174 24
Burley, ID $124.90 $49.84 – $187.60 38,219 11
Pottsville, PA $104.80 $21.62 – $195.11 38,252 16
Baytown, TX $192.43 $23.89 – $993.21 38,253 35
Cambridge, MD $85.78 $18.75 – $136.66 38,262 12
Sikeston, MO $114.76 $30.76 – $455.23 38,264 13
Kermit, TX $68.82 $68.82 – $68.82 38,283 1
Flemingsburg, KY $222.28 $35.95 – $269.33 38,344 4
Mcminnville, OR $142.88 $78.66 – $201.81 38,370 7

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.