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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
Lexington, NC $114.36 $49.12 – $205.64 71,313 16
Cheraw, SC $38.33 $29.11 – $67.11 71,382 5
Marysville, OH $115.58 $55.88 – $186.44 71,426 12
Athens, TN $83.39 $19.37 – $196.43 71,429 15
Marshfield, WI $46.05 $19.98 – $149.30 71,524 33
Red Bank, NJ $208.20 $31.22 – $297.43 71,589 25
Athens, AL $45.82 $16.29 – $126.18 71,649 18
Arlington, WA $111.67 $36.66 – $123.26 71,689 10
Sulphur, LA $87.52 $26.95 – $132.68 71,718 10
Athens, OH $94.95 $47.02 – $116.06 71,756 16
Columbus, IN $94.38 $31.45 – $166.76 71,827 30
Jupiter, FL $100.07 $34.48 – $275.36 71,963 22
Waukegan, IL $63.55 $27.20 – $170.65 72,011 15
Texarkana, AR $110.93 $31.28 – $258.20 72,064 24
Fayetteville, AR $74.56 $1.72 – $147.32 72,096 39
Tualatin, OR $156.28 $109.20 – $210.85 72,130 16
Gardner, MA $114.93 $39.97 – $141.26 72,139 14
Clanton, AL $82.54 $32.91 – $108.97 72,298 11
West Monroe, LA $79.75 $19.12 – $171.39 72,385 19
Marion, VA $113.87 $34.26 – $127.38 72,441 7
Riverhead, NY $133.61 $35.62 – $420.32 72,459 20
Hazleton, PA $99.23 $34.39 – $272.09 72,608 18
Corvallis, OR $154.99 $10.89 – $303.05 72,735 26
Stuart, FL $69.82 $26.62 – $181.83 72,853 35
Buckeye, AZ $182.59 $90.00 – $193.97 73,020 3
Sunnyside, WA $215.18 $36.09 – $222.72 73,082 7
Ludington, MI $119.62 $15.03 – $150.86 73,165 6
Ronceverte, WV $115.42 $40.82 – $231.07 73,237 16
Anniston, AL $48.94 $3.58 – $228.21 73,355 23
Jefferson City, TN $126.29 $41.48 – $159.72 73,516 14
Miramar, FL $68.89 $0.00 – $258.81 73,521 28
Cortland, NY $141.85 $46.11 – $181.99 73,751 14
Winnsboro, LA $117.17 $29.77 – $366.51 73,807 10
Taunton, MA $135.54 $36.77 – $184.05 73,859 19
Brooksville, FL $80.53 $13.11 – $178.85 73,868 31
Greenfield, MA $98.36 $18.71 – $152.71 73,913 18
Crown Point, IN $102.57 $25.30 – $167.73 73,922 22
Garfield Heights, OH $100.64 $29.40 – $117.16 74,034 12
Martin, KY $177.34 $5.60 – $257.55 74,067 6
Keene, NH $73.14 $20.37 – $163.04 74,086 41
Boaz, AL $42.96 $15.48 – $54.96 74,131 16
Davenport, FL $62.21 $15.41 – $171.88 74,143 25
Greenville, KY $127.48 $41.86 – $151.21 74,334 6
Garden Grove, CA $58.98 $0.00 – $137.78 74,473 24
Demorest, GA $136.69 $77.63 – $172.15 74,477 8
Marshalltown, IA $154.51 $28.10 – $268.50 74,521 19
Huntington Beach, CA $71.05 $0.00 – $135.42 74,578 32
Monticello, KY $135.90 $39.74 – $221.81 74,762 6
Neenah, WI $46.48 $13.02 – $65.47 74,878 10
Grand Forks, ND $149.45 $55.80 – $274.50 74,908 30

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.