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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
Phila, PA $170.79 $42.07 – $336.43 58,011 17
Barstow, CA $63.05 $42.99 – $88.64 58,026 6
Kosciusko, MS $99.03 $10.30 – $116.14 58,040 4
Caldwell, ID $130.63 $55.89 – $201.59 58,134 12
Burlingame, CA $71.62 $0.00 – $105.34 58,216 33
Cordova, TN $89.68 $7.00 – $148.87 58,275 18
Chicago Ridge, IL $94.71 $30.35 – $137.31 58,323 20
Hannibal, MO $110.45 $33.97 – $386.54 58,450 17
Sedro Woolley, WA $417.72 $60.77 – $555.99 58,471 5
Laguna Hills, CA $51.53 $9.85 – $114.42 58,477 19
Caribou, ME $34.03 $24.79 – $92.93 58,488 8
Covington, TN $83.12 $24.40 – $99.23 58,602 8
Katy, TX $163.34 $0.00 – $1,240 58,611 48
Joshua Tree, CA $58.10 $48.47 – $72.56 58,615 7
Rockport, ME $144.41 $25.06 – $178.81 58,631 20
Barrington, IL $63.91 $49.68 – $215.91 58,663 23
Ocoee, FL $72.49 $25.20 – $167.49 58,823 19
Austintown, OH $83.41 $6.45 – $112.02 58,868 9
Batesville, AR $66.12 $0.00 – $95.59 58,889 16
Placentia, CA $70.97 $15.46 – $144.79 59,021 17
Kenansville, NC $89.79 $48.81 – $206.51 59,048 10
Clarkston, WA $155.85 $31.74 – $208.66 59,111 8
Irvine, KY $111.03 $41.16 – $128.01 59,222 3
Oxford, OH $92.09 $41.95 – $122.25 59,279 9
Payson, AZ $257.13 $59.78 – $369.00 59,337 12
Willits, CA $110.86 $0.00 – $112.17 59,370 4
Plymouth, NH $119.47 $22.64 – $147.07 59,474 9
Salem, NJ $245.53 $203.27 – $275.34 59,482 4
Leesburg, FL $68.04 $30.95 – $323.75 59,483 23
Du Bois, PA $88.65 $0.21 – $269.95 59,529 26
Lafayette, CO $100.40 $15.15 – $184.40 59,656 19
Bryan, TX $97.85 $3.48 – $316.98 59,677 39
Niagara Falls, NY $112.95 $5.35 – $131.49 59,751 15
South El Monte, CA $51.87 $25.38 – $122.45 59,811 8
Coupeville, WA $199.98 $34.09 – $256.21 59,819 8
Culver City, CA $72.07 $30.43 – $106.50 59,995 18
Placerville, CA $60.70 $6.96 – $133.99 60,050 15
Lebanon, VA $124.12 $59.16 – $140.73 60,087 4
Newberg, OR $224.98 $0.00 – $405.83 60,230 14
Oregon City, OR $146.42 $43.83 – $250.09 60,232 13
Harris, NY $154.81 $31.67 – $171.58 60,240 6
Plant City, FL $64.37 $13.14 – $208.97 60,249 19
Secaucus, NJ $199.25 $35.04 – $324.98 60,257 9
Woodstock, VA $203.66 $43.77 – $243.60 60,277 6
Papillion, NE $105.02 $47.85 – $159.12 60,364 13
Hazlehurst, MS $115.42 $1.91 – $172.57 60,374 6
Stanford, KY $118.12 $27.53 – $135.92 60,544 4
Clarksdale, MS $95.39 $0.61 – $305.43 60,642 12
Port Jefferson, NY $144.34 $15.04 – $168.04 60,665 22
Moncks Corner, SC $78.02 $48.08 – $96.84 60,715 14

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.