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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
Littleton, CO $88.30 $0.00 – $265.92 63,750 52
Cedar City, UT $50.70 $26.78 – $154.02 63,759 18
Barbourville, KY $199.07 $33.66 – $244.34 63,843 4
Greenwood Village, CO $132.03 $0.00 – $210.75 63,922 82
Collierville, TN $105.01 $49.51 – $150.54 63,926 10
Waynesboro, MS $97.21 $15.25 – $132.24 63,953 8
Cynthiana, KY $107.18 $38.50 – $147.51 64,017 10
Mount Vernon, OH $86.82 $46.30 – $131.52 64,145 12
Stafford, VA $188.99 $45.37 – $189.68 64,223 2
Macungie, PA $87.97 $57.71 – $242.59 64,390 13
King City, CA $73.24 $54.65 – $81.72 64,484 3
Bisbee, AZ $333.37 $63.95 – $348.01 64,512 6
Norwalk, CA $54.89 $39.50 – $106.60 64,520 13
Dublin, OH $87.07 $25.79 – $159.49 64,685 33
Lenoir City, TN $80.27 $46.11 – $135.65 64,770 9
Newberry, SC $46.70 $39.81 – $72.33 64,780 5
Statesville, NC $111.38 $44.54 – $210.83 64,854 23
Claremore, OK $149.67 $81.75 – $245.44 64,883 12
Ormond Beach, FL $75.96 $38.99 – $90.54 64,911 16
Big Rapids, MI $157.87 $74.47 – $163.63 64,922 2
Lewes, DE $92.80 $8.26 – $157.83 64,937 19
Kalkaska, MI $110.50 $42.61 – $161.61 64,971 5
Mckinney, TX $138.06 $22.69 – $499.24 64,983 40
Cooperstown, NY $106.43 $20.15 – $184.35 65,007 38
Seymour, IN $93.73 $24.02 – $159.18 65,023 15
Fremont, MI $212.66 $10.33 – $215.13 65,083 2
West Branch, MI $113.08 $52.85 – $165.02 65,127 3
Montrose, CO $110.30 $39.38 – $1,321 65,162 19
Gassaway, WV $95.61 $48.66 – $212.37 65,266 6
Longmont, CO $100.50 $12.98 – $175.20 65,355 35
Tarboro, NC $81.05 $45.53 – $88.92 65,487 10
Arcata, CA $76.57 $0.00 – $274.35 65,552 21
Marion, IL $92.19 $30.17 – $123.11 65,663 11
Lebanon, IN $71.72 $15.03 – $86.27 65,670 14
Berwyn, IL $71.90 $44.61 – $497.12 65,678 19
Meridian, ID $86.84 $38.41 – $224.16 65,721 40
Escanaba, MI $143.13 $21.43 – $226.10 65,823 5
Mequon, WI $45.05 $17.66 – $95.01 65,881 18
Elizabeth City, NC $89.73 $41.90 – $165.80 66,080 17
Pompton Plains, NJ $250.10 $40.67 – $274.77 66,165 11
Warrenton, VA $120.41 $45.05 – $161.81 66,217 19
Carlsbad, NM $154.57 $61.71 – $171.12 66,228 7
Mount Vernon, KY $108.98 $48.96 – $135.67 66,581 7
West Point, MS $120.68 $17.60 – $159.64 66,652 8
Issaquah, WA $96.95 $44.80 – $147.40 66,792 22
Plymouth, MA $149.87 $18.67 – $238.65 66,869 25
San Pablo, CA $98.38 $70.61 – $145.25 67,003 8
Milford, CT $176.22 $0.00 – $295.42 67,047 10
Huntington Park, CA $62.52 $0.00 – $148.13 67,145 12
Port Townsend, WA $270.87 $37.95 – $410.66 67,159 9

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.