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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
Wahiawa, HI $360.09 $0.00 – $385.59 40,657 3
Coronado, CA $238.24 $42.26 – $421.67 40,675 9
Angola, IN $118.57 $47.37 – $568.45 40,683 7
Amery, WI $154.53 $28.30 – $340.26 40,690 25
Troy, AL $41.52 $25.83 – $44.39 40,765 12
Bryan, OH $87.00 $38.84 – $147.81 40,851 9
Murrells Inlet, SC $43.57 $30.44 – $80.19 40,855 10
Prince Frederick, MD $83.78 $19.87 – $174.04 40,872 19
Tallassee, AL $52.69 $24.46 – $84.21 40,965 4
Sonoma, CA $82.90 $0.00 – $117.46 41,051 17
Sheffield, AL $66.14 $27.10 – $131.56 41,056 12
Rowlett, TX $98.89 $64.64 – $120.87 41,117 11
Carson City, MI $112.98 $57.74 – $170.41 41,231 2
Grass Valley, CA $81.02 $0.00 – $638.72 41,251 21
Arecibo, PR $38.32 $2.52 – $101.32 41,294 38
Polson, MT $58.08 $11.36 – $160.11 41,370 15
Ashland, WI $136.39 $23.70 – $164.19 41,457 6
Ashland, OH $93.67 $35.99 – $126.37 41,503 7
Scottsbluff, NE $107.29 $55.56 – $386.02 41,535 13
Kirksville, MO $116.40 $49.21 – $195.08 41,580 11
Kenmore, NY $158.59 $36.90 – $180.02 41,625 7
Ellenville, NY $240.25 $60.95 – $325.06 41,631 3
Winfield, IL $68.46 $23.61 – $128.44 41,652 30
West Jordan, UT $21.79 $13.45 – $151.75 41,666 13
Warner Robins, GA $77.93 $36.53 – $99.79 41,724 24
Boca Raton, FL $67.71 $0.00 – $197.52 41,767 70
Jackson, CA $75.11 $0.00 – $164.63 41,791 8
Greensboro, GA $62.77 $62.30 – $71.96 41,797 2
Lexington, MS $98.64 $20.84 – $111.42 41,803 4
Melrose Park, IL $59.74 $31.78 – $140.72 41,909 25
Lincolnton, NC $131.31 $0.00 – $196.67 41,967 15
Seminole, OK $156.76 $92.82 – $191.09 42,061 6
Bentonville, AR $78.20 $2.30 – $127.79 42,077 18
Skokie, IL $63.82 $28.40 – $141.89 42,083 21
Rhinelander, WI $45.66 $18.42 – $172.02 42,208 15
Westmont, IL $67.48 $40.60 – $170.95 42,247 17
Brighton, CO $110.30 $0.31 – $123.35 42,301 11
Parsippany, NJ $76.04 $43.29 – $119.16 42,310 23
Zeeland, MI $159.41 $128.52 – $167.83 42,331 2
North Conway, NH $134.61 $25.19 – $378.40 42,464 20
Lake City, FL $60.12 $7.17 – $83.20 42,471 23
Geneva, OH $103.37 $44.50 – $139.48 42,494 10
Reed City, MI $198.87 $198.87 – $198.87 42,504 1
Sedona, AZ $93.58 $51.53 – $153.21 42,518 10
Kaplan, LA $94.67 $80.92 – $106.84 42,613 3
Delta, CO $103.58 $68.07 – $221.47 42,632 13
Manati, PR $42.73 $0.63 – $198.71 42,643 30
Logan, OH $90.51 $40.07 – $155.58 42,702 18
Stockbridge, GA $79.15 $48.73 – $120.52 42,735 18
Susanville, CA $64.28 $0.00 – $78.80 42,748 17

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.