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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
Livingston, TN $81.69 $41.22 – $255.33 47,056 6
Socorro, NM $222.88 $29.67 – $276.43 47,079 7
Breaux Bridge, LA $104.37 $53.62 – $127.49 47,115 8
Carrollton, KY $118.58 $50.33 – $154.16 47,176 5
Benton, KY $109.47 $32.20 – $196.15 47,212 12
West Valley City, UT $45.57 $24.91 – $252.04 47,226 11
Ahoskie, NC $97.37 $49.44 – $116.84 47,237 7
Suffern, NY $172.69 $24.93 – $181.66 47,238 8
Vero Beach, FL $66.30 $7.09 – $114.51 47,259 29
Lufkin, TX $122.50 $9.92 – $192.29 47,265 16
Harvey, LA $129.24 $82.95 – $207.55 47,274 10
Coos Bay, OR $91.33 $31.01 – $357.59 47,281 19
Huron, SD $29.44 $27.69 – $102.64 47,346 7
Newark, NY $134.50 $58.12 – $271.87 47,433 14
Camp Hill, PA $149.26 $31.66 – $209.35 47,515 31
Linton, IN $83.40 $24.93 – $90.05 47,520 9
Fishers, IN $102.59 $35.48 – $160.04 47,538 22
Searcy, AR $76.67 $0.59 – $157.39 47,579 22
Mcminnville, TN $95.76 $5.41 – $129.79 47,656 19
Hardeeville, SC $42.26 $37.37 – $83.14 47,656 8
Gaylord, MI $147.17 $51.27 – $152.89 47,671 4
Sleepy Hollow, NY $145.28 $37.92 – $308.16 47,736 19
Dorchester, MA $99.48 $44.90 – $394.35 47,895 10
El Centro, CA $75.70 $0.10 – $104.84 47,915 17
Truth Or Consequences, NM $214.80 $99.44 – $341.94 47,937 4
Oneonta, NY $162.90 $10.30 – $188.04 47,968 7
Cheektowaga, NY $135.96 $22.07 – $175.47 47,974 12
Bremen, GA $143.14 $55.94 – $154.72 48,019 5
Winfield, AL $49.45 $18.50 – $88.63 48,028 6
Presque Isle, ME $144.67 $2.70 – $179.05 48,032 12
Aguadilla, PR $45.91 $0.00 – $100.21 48,037 19
Franklin, IN $88.89 $26.32 – $106.91 48,093 11
La Plata, MD $102.86 $39.05 – $148.36 48,225 14
Many, LA $75.67 $22.42 – $203.89 48,279 11
Austin, MN $208.91 $81.31 – $300.20 48,291 23
Colville, WA $167.42 $25.31 – $190.44 48,317 10
Canon City, CO $105.50 $59.68 – $183.92 48,378 11
Paw Paw, MI $161.66 $161.66 – $161.66 48,390 1
Thousand Oaks, CA $121.27 $10.64 – $263.82 48,434 26
Newton, MA $141.52 $33.94 – $183.32 48,477 18
Flemington, NJ $209.85 $39.47 – $268.10 48,508 18
Wiggins, MS $71.47 $31.12 – $151.15 48,521 9
Cass City, MI $123.79 $69.39 – $227.67 48,716 5
West Plains, MO $101.70 $37.46 – $130.87 48,737 14
Luling, LA $104.16 $49.57 – $240.70 48,746 9
Nags Head, NC $94.75 $44.77 – $180.66 48,747 14
Va Beach, VA $68.27 $44.48 – $93.81 48,750 14
Austell, GA $86.90 $32.97 – $113.68 48,753 23
Rexburg, ID $96.77 $42.92 – $454.28 48,771 12
Fairfax, SC $33.83 $20.05 – $65.89 48,829 3

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.