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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
Marshall, MI $158.49 $72.48 – $183.59 54,903 6
Machias, ME $13.55 $12.13 – $93.82 54,971 5
Washington, NC $98.67 $51.34 – $215.79 55,023 18
Lewiston, ID $69.45 $29.06 – $124.64 55,045 25
Hartford, WI $62.64 $20.09 – $154.01 55,079 21
Gettysburg, PA $109.26 $18.97 – $270.36 55,163 23
Ada, OK $154.30 $17.53 – $198.75 55,166 31
Juneau, AK $267.27 $44.07 – $329.69 55,194 16
Taos, NM $199.76 $81.43 – $269.89 55,199 8
Altus, OK $142.93 $84.66 – $228.94 55,273 11
Oro Valley, AZ $135.14 $56.43 – $149.59 55,286 6
Fairhope, AL $74.00 $35.55 – $137.55 55,397 17
Rome, NY $131.56 $53.65 – $136.45 55,449 6
Cortlandt Manor, NY $142.42 $39.39 – $175.93 55,476 9
Hollister, CA $67.13 $2.38 – $78.01 55,634 8
Rio Rancho, NM $156.64 $72.56 – $179.13 55,648 13
Mt Pleasant, MI $155.42 $94.53 – $241.12 55,723 3
Ithaca, NY $140.66 $42.40 – $162.63 55,803 17
Batavia, NY $122.45 $46.23 – $144.27 56,079 14
Greeneville, TN $93.18 $10.42 – $158.08 56,230 16
Fairmont, WV $107.25 $50.98 – $303.46 56,270 12
Blue Island, IL $61.08 $35.70 – $171.57 56,282 13
El Segundo, CA $61.24 $19.89 – $80.90 56,288 10
Oroville, CA $58.66 $0.00 – $730.88 56,319 18
Tawas City, MI $130.01 $77.71 – $149.29 56,372 3
Sunnyvale, TX $86.18 $33.50 – $304.66 56,389 15
Ionia, MI $170.06 $57.85 – $226.34 56,402 2
Pearland, TX $120.37 $32.22 – $289.50 56,547 22
Harriman, TN $98.79 $54.93 – $311.54 56,690 10
Newburgh, IN $92.11 $33.27 – $222.06 56,743 21
Travis Afb, CA $79.69 $14.20 – $164.08 56,890 37
Roosevelt, UT $69.74 $38.91 – $200.01 56,906 11
Milford, MA $139.16 $5.03 – $180.07 56,976 22
Daly City, CA $68.48 $8.62 – $254.12 57,018 23
Lexington, SC $74.27 $3.55 – $114.10 57,026 19
Uniontown, PA $82.32 $47.24 – $137.74 57,038 23
Brandon, MS $97.53 $18.55 – $120.57 57,093 9
Calais, ME $32.81 $14.03 – $107.27 57,217 10
Cambridge, OH $90.64 $42.06 – $129.02 57,365 12
Greenwood, IN $90.55 $28.65 – $141.05 57,376 27
El Dorado, KS $67.71 $48.30 – $72.03 57,544 5
Marina Del Rey, CA $56.84 $12.36 – $136.33 57,547 22
Corning, NY $114.43 $64.72 – $131.20 57,624 8
Jber, AK $146.73 $34.63 – $197.10 57,638 20
Live Oak, TX $139.00 $0.00 – $421.63 57,716 19
Kealakekua, HI $318.76 $61.59 – $399.60 57,723 7
Wisconsin Rapids, WI $50.14 $20.04 – $82.06 57,760 10
Fort Polk, LA $102.85 $52.70 – $312.69 57,764 13
Fort Payne, AL $53.88 $26.02 – $126.10 57,898 14
Greenville, MI $179.58 $10.70 – $180.67 57,923 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.