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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
Medina, OH $89.31 $37.10 – $113.89 48,894 15
Simpsonville, SC $30.24 $12.34 – $133.01 48,944 5
Jackson, OH $94.81 $50.48 – $154.36 48,997 6
Fort Atkinson, WI $53.41 $12.15 – $222.10 49,098 12
Beaver Dam, WI $44.49 $22.97 – $123.04 49,137 13
Franklinton, LA $110.24 $37.74 – $220.55 49,145 7
Barberton, OH $77.28 $41.01 – $150.44 49,242 14
Sparks, NV $90.03 $0.00 – $205.67 49,316 30
Tazewell, VA $116.17 $48.72 – $151.45 49,460 9
Chesterfield, MO $113.69 $16.62 – $427.66 49,522 40
Lucedale, MS $64.64 $16.42 – $84.96 49,547 12
Morganton, NC $108.35 $26.59 – $324.66 49,555 21
Varnville, SC $73.08 $36.69 – $127.21 49,777 2
South Miami, FL $77.33 $0.00 – $194.74 49,812 51
East Stroudsburg, PA $121.03 $0.00 – $165.85 49,927 15
Brighton, MA $74.21 $24.61 – $126.17 49,984 32
Mountain View, CA $55.03 $0.00 – $156.94 50,063 33
Mountain Home, AR $57.35 $35.62 – $159.96 50,127 23
Encino, CA $49.51 $39.46 – $109.61 50,136 16
Olathe, KS $68.68 $26.18 – $411.98 50,211 38
Olean, NY $174.22 $24.64 – $203.91 50,354 8
Mt Pleasant, SC $57.74 $36.60 – $98.70 50,384 9
Mcalester, OK $127.26 $74.08 – $233.20 50,413 12
Mount Kisco, NY $125.03 $37.26 – $176.63 50,417 19
Greencastle, IN $81.53 $37.23 – $135.01 50,457 7
Rogers, AR $60.67 $25.74 – $383.44 50,477 25
Mesquite, TX $109.77 $12.89 – $203.69 50,480 19
Mooresville, NC $75.72 $25.40 – $174.52 50,485 23
Carthage, MS $97.12 $13.68 – $114.69 50,518 7
Summit, WI $48.76 $23.54 – $85.38 50,561 17
Yukon, OK $144.52 $60.04 – $190.61 50,596 15
Madison, AL $47.94 $17.60 – $67.91 50,676 19
Abington, PA $112.96 $38.70 – $198.99 50,807 35
Loxahatchee, FL $91.29 $42.33 – $179.88 50,852 11
Saratoga Springs, NY $109.88 $7.72 – $197.50 50,858 39
Ellsworth, ME $138.85 $24.23 – $190.99 50,931 12
Port Charlotte, FL $64.51 $26.48 – $102.27 51,021 35
West Bloomfield, MI $189.76 $34.06 – $217.73 51,039 10
Oak Hill, WV $137.71 $90.50 – $201.42 51,080 5
Rancho Cucamonga, CA $67.83 $19.98 – $120.38 51,113 11
Franklin, KY $173.62 $89.10 – $251.95 51,120 3
Brevard, NC $127.85 $69.50 – $220.33 51,151 14
Palmetto Bay, FL $68.96 $1.78 – $106.81 51,283 22
Tinley Park, IL $55.95 $41.84 – $79.15 51,293 13
Xenia, OH $100.40 $39.53 – $135.43 51,342 9
Two Rivers, WI $53.53 $26.69 – $60.70 51,389 8
Pittsfield, ME $28.96 $19.32 – $69.25 51,470 4
Bridgton, ME $16.14 $16.14 – $16.14 51,479 1
North Las Vegas, NV $77.90 $1.13 – $933.85 51,538 34
Columbia, MS $111.37 $26.75 – $133.22 51,560 6

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.