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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
Bunkie, LA $91.76 $79.76 – $92.54 60,810 2
Guaynabo, PR $74.74 $0.11 – $113.64 60,878 34
Cottage Grove, OR $175.59 $74.36 – $235.48 60,883 13
Jasper, TN $105.76 $58.60 – $134.80 61,120 7
Conway, AR $45.06 $30.90 – $100.85 61,165 27
Weston, WI $45.38 $16.16 – $161.59 61,272 21
Globe, AZ $326.56 $17.22 – $378.65 61,308 9
Burlington, WI $48.14 $22.55 – $84.06 61,331 23
Herrin, IL $52.48 $34.23 – $83.19 61,459 11
Mount Pleasant, WI $52.13 $16.82 – $123.15 61,592 21
Enumclaw, WA $240.82 $58.04 – $427.36 61,607 10
Lewisville, TX $113.51 $63.99 – $171.71 61,752 17
Bluefield, WV $101.58 $36.17 – $165.50 61,754 16
Orange City, FL $74.58 $13.97 – $317.14 61,824 24
El Dorado, AR $63.46 $0.50 – $93.96 61,837 18
Vacaville, CA $183.01 $0.15 – $892.14 62,018 34
Frisco, TX $151.69 $26.62 – $360.42 62,021 37
Manteca, CA $257.93 $7.96 – $343.51 62,043 19
Fort Dodge, IA $118.97 $41.02 – $201.34 62,111 15
Largo, FL $68.70 $2.46 – $203.84 62,206 32
Woodland Hills, CA $288.45 $0.00 – $447.15 62,267 26
Madison, WV $108.69 $38.52 – $204.74 62,296 6
Plainsboro, NJ $320.09 $12.48 – $363.57 62,326 14
Kinston, NC $77.12 $40.30 – $202.42 62,443 19
Tulare, CA $48.87 $13.89 – $113.30 62,466 12
Farmington, MO $132.07 $32.55 – $401.51 62,493 15
Russell Springs, KY $120.65 $41.44 – $143.77 62,632 5
Lenoir, NC $120.83 $44.93 – $230.89 62,663 13
Webster, TX $141.64 $24.60 – $628.00 62,747 44
Rutland, VT $51.75 $0.00 – $193.38 62,861 28
Bartlesville, OK $117.43 $41.25 – $256.04 62,928 21
Lebanon, TN $117.54 $0.00 – $259.73 62,947 17
Merrillville, IN $97.51 $27.59 – $177.14 62,956 18
Lihue, HI $348.29 $2.88 – $510.39 62,966 14
Maumee, OH $74.62 $42.51 – $96.75 63,125 19
Sault Sainte Marie, MI $106.32 $36.95 – $164.64 63,125 4
Frederick, MD $76.66 $15.54 – $256.93 63,284 40
Middleburg Heights, OH $79.56 $5.70 – $86.26 63,297 18
Ashtabula, OH $100.95 $25.59 – $142.72 63,329 13
Tappahannock, VA $177.84 $21.84 – $198.24 63,349 8
Monroeville, PA $97.78 $0.00 – $325.39 63,360 23
Winslow, AZ $321.90 $8.91 – $392.41 63,403 11
Lawrenceville, GA $102.83 $12.10 – $176.56 63,406 38
Potsdam, NY $121.43 $6.68 – $147.93 63,407 24
Casper, WY $106.21 $52.11 – $296.56 63,438 26
Easley, SC $30.00 $16.94 – $108.75 63,526 9
Russellville, KY $114.27 $37.96 – $153.87 63,542 6
La Follette, TN $119.81 $41.24 – $206.01 63,577 10
Havre, MT $36.40 $11.40 – $207.49 63,624 11
Westminster, MD $98.00 $31.79 – $210.71 63,727 28

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.