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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
Maryville, IL $65.04 $34.55 – $95.46 51,645 12
Templeton, CA $61.96 $9.54 – $84.02 51,669 17
Roanoke Rapids, NC $83.99 $37.80 – $155.50 51,720 12
Elmer, NJ $422.29 $56.49 – $497.68 51,742 2
Apache Junction, AZ $285.07 $71.48 – $285.32 51,807 2
Paramus, NJ $146.99 $16.29 – $332.06 51,821 34
Massena, NY $105.67 $30.94 – $148.97 51,866 7
East Chicago, IN $97.96 $0.00 – $203.11 51,913 11
Washington Court House, OH $106.45 $44.57 – $145.47 51,923 11
Towson, MD $87.30 $13.89 – $222.77 51,964 47
Williamstown, KY $409.05 $409.05 – $409.05 52,067 1
South San Francisco, CA $151.09 $19.41 – $246.46 52,085 21
Lawrenceburg, IN $89.45 $33.78 – $140.71 52,227 10
Greenville, OH $92.80 $75.02 – $129.24 52,256 7
Iron Mountain, MI $110.43 $22.11 – $147.74 52,298 6
Mount Shasta, CA $142.65 $0.00 – $184.52 52,390 13
Dixon, IL $49.99 $26.83 – $74.15 52,583 14
Bronxville, NY $151.64 $71.14 – $163.78 52,656 20
Fort Defiance, AZ $69.81 $0.00 – $105.03 52,670 36
Davie, FL $92.47 $22.55 – $202.12 52,823 21
Hudson, NY $103.12 $37.15 – $129.01 52,837 10
Bedford, IN $85.77 $42.24 – $102.62 52,885 11
Silver City, NM $194.36 $1.62 – $228.51 52,932 9
American Fork, UT $51.02 $21.20 – $196.62 52,983 16
Elkhorn, WI $49.61 $11.65 – $58.99 53,104 13
Mount Vernon, NY $136.46 $15.24 – $198.79 53,150 10
Coushatta, LA $125.22 $91.90 – $256.43 53,199 9
Healdsburg, CA $112.49 $0.00 – $174.61 53,202 11
Oswego, NY $147.65 $48.15 – $166.64 53,203 8
Demopolis, AL $35.68 $2.34 – $40.61 53,209 7
Logan, UT $50.36 $15.57 – $256.58 53,233 16
Grand Haven, MI $110.83 $57.49 – $180.84 53,350 5
Hanover, PA $86.22 $54.62 – $205.11 53,401 25
Yazoo City, MS $121.10 $19.58 – $135.12 53,521 4
Low Moor, VA $130.64 $44.04 – $149.21 53,523 4
Rochester, MI $148.06 $62.77 – $211.80 53,592 5
Denton, TX $91.32 $6.58 – $151.30 53,620 31
Lebanon, MO $143.20 $33.67 – $401.63 53,668 18
Albemarle, NC $113.26 $46.95 – $445.33 53,866 19
Fort Bragg, CA $125.21 $0.00 – $527.27 53,930 12
Gilroy, CA $74.08 $4.07 – $93.21 53,953 10
Smyrna, GA $64.06 $34.30 – $82.33 54,002 12
Geneva, NY $109.17 $59.27 – $152.40 54,031 12
Woonsocket, RI $66.94 $38.20 – $189.82 54,055 20
Union, SC $49.10 $46.17 – $65.08 54,118 3
Damariscotta, ME $15.42 $14.49 – $142.80 54,127 3
Cheyenne, WY $101.85 $2.11 – $173.67 54,483 37
Paris, KY $190.06 $60.33 – $241.93 54,745 6
Weslaco, TX $133.81 $43.12 – $603.75 54,787 20
Ridgewood, NJ $255.05 $27.63 – $301.78 54,793 21

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.