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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
Alton, IL $62.67 $33.98 – $216.42 67,242 22
Bogalusa, LA $77.85 $31.27 – $226.09 67,299 27
Middlesboro, KY $199.81 $56.88 – $256.08 67,317 6
Three Rivers, MI $138.11 $36.65 – $190.36 67,359 6
Brunswick, ME $197.14 $26.63 – $241.93 67,426 19
Canton, MS $113.30 $8.05 – $116.85 67,590 4
Lawrence, KS $65.48 $19.66 – $141.23 67,658 23
Miamisburg, OH $99.60 $30.32 – $175.13 67,672 9
Upper Marlboro, MD $282.65 $40.23 – $289.50 67,713 11
Butte, MT $31.49 $15.43 – $100.21 67,874 11
Fort Pierce, FL $65.12 $1.40 – $147.56 67,986 38
Fort Campbell, KY $84.47 $0.00 – $223.40 68,002 32
Waupaca, WI $112.77 $19.21 – $168.75 68,035 23
Mission Viejo, CA $76.89 $0.09 – $146.15 68,153 37
Decatur, AL $54.32 $0.00 – $247.59 68,321 34
Brainerd, MN $164.31 $2.94 – $639.11 68,468 24
Milwaukie, OR $156.10 $0.91 – $270.38 68,469 15
Parkland, FL $92.72 $58.04 – $103.54 68,605 7
Hamilton, MT $47.86 $19.51 – $119.37 68,688 12
Bloomington, IL $77.68 $22.18 – $145.64 68,895 27
Rockville Centre, NY $117.42 $16.07 – $162.76 68,936 16
Amory, MS $134.33 $23.46 – $172.78 69,012 10
Whitesburg, KY $184.38 $64.52 – $241.35 69,120 5
Eden, NC $114.83 $47.06 – $176.70 69,244 12
Mayaguez, PR $68.86 $0.00 – $199.01 69,247 33
St Thomas, VI $51.04 $48.25 – $141.05 69,316 4
Pickens, SC $37.44 $28.95 – $55.34 69,330 3
Randallstown, MD $90.14 $27.53 – $203.48 69,393 38
Houlton, ME $18.25 $18.24 – $45.41 69,403 2
Hermitage, TN $136.86 $5.85 – $233.17 69,500 27
Eunice, LA $115.50 $28.13 – $356.19 69,636 10
Novato, CA $84.63 $0.00 – $144.06 69,770 11
Lone Tree, CO $96.82 $9.42 – $164.85 69,772 28
Gladwin, MI $114.69 $51.15 – $163.30 69,803 4
Normal, IL $76.66 $28.62 – $126.07 69,820 28
Guayama, PR $64.35 $0.00 – $121.32 70,012 37
Page, AZ $217.81 $48.91 – $363.67 70,235 6
Lincoln, ME $66.71 $11.57 – $149.54 70,263 4
Dover Foxcroft, ME $15.83 $13.68 – $426.58 70,269 6
Scranton, PA $84.18 $25.75 – $378.48 70,317 38
Cadillac, MI $137.05 $57.43 – $150.37 70,447 5
Ellensburg, WA $158.77 $30.83 – $215.93 70,498 12
Glen Dale, WV $102.76 $46.93 – $148.95 70,527 14
Crestview, FL $55.29 $18.59 – $123.26 70,554 20
Gloucester, VA $134.56 $55.90 – $152.34 70,583 10
Marinette, WI $64.98 $25.45 – $86.87 70,586 24
Loveland, CO $97.88 $0.00 – $159.98 70,771 27
Batesville, IN $90.48 $3.94 – $152.45 71,074 14
Clinton, NC $76.25 $34.08 – $134.76 71,091 11
Bemidji, MN $168.83 $39.45 – $671.70 71,098 22

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.