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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
San Luis Obispo, CA $66.44 $3.42 – $114.76 74,927 32
Smithfield, NC $112.22 $33.58 – $276.61 74,939 17
Gaffney, SC $43.22 $26.62 – $66.38 75,100 9
Bedford, VA $130.41 $52.22 – $160.74 75,393 5
North Providence, RI $105.97 $19.88 – $245.90 75,520 15
Artesia, NM $96.23 $25.13 – $174.11 75,530 9
Santa Clara, CA $90.22 $1.90 – $288.89 75,545 45
Stafford Springs, CT $198.37 $24.93 – $290.55 75,602 12
Elkins, WV $90.84 $59.57 – $216.28 75,766 13
Mullica Hill, NJ $470.03 $11.60 – $510.68 75,790 8
Farmington, ME $126.23 $10.15 – $344.21 75,794 20
Ewa Beach, HI $520.26 $55.87 – $742.72 76,046 10
Arcadia, CA $65.43 $21.67 – $219.35 76,059 27
Freeport, IL $88.36 $31.88 – $126.06 76,098 14
Valdosta, GA $94.06 $43.18 – $157.76 76,137 23
La Grange, KY $97.95 $13.37 – $161.56 76,145 13
Midland, TX $69.25 $31.50 – $173.47 76,221 36
New Braunfels, TX $107.89 $40.48 – $295.36 76,226 31
Lovington, NM $176.06 $65.75 – $268.44 76,288 15
Rumford, ME $11.38 $11.38 – $11.38 76,295 1
Auburn, IN $111.64 $100.21 – $126.24 76,479 7
Galion, OH $82.94 $32.54 – $128.58 76,535 19
Mattoon, IL $58.82 $25.94 – $124.45 76,576 30
Westfield, MA $131.83 $27.52 – $179.93 76,594 26
Winnfield, LA $101.88 $61.50 – $236.11 76,630 6
Onancock, VA $151.64 $60.93 – $154.46 76,655 5
Hobbs, NM $141.84 $51.08 – $194.46 76,724 9
Soldotna, AK $306.45 $64.41 – $443.13 76,734 16
Nellis Afb, NV $92.87 $20.09 – $179.39 76,735 45
Rocky Mount, VA $154.43 $54.61 – $186.80 76,799 10
Howell, MI $152.78 $50.09 – $173.30 76,861 5
Galveston, TX $176.51 $13.20 – $501.28 76,863 42
Bethesda, MD $94.08 $0.00 – $183.60 77,005 57
Dayton, TN $93.75 $51.98 – $109.60 77,072 8
Watertown, NY $117.44 $24.41 – $150.42 77,183 20
Minot, ND $150.77 $14.84 – $210.55 77,309 29
Jefferson City, MO $119.12 $36.36 – $424.99 77,320 37
Los Alamitos, CA $61.74 $20.90 – $100.35 77,439 26
Gonzales, LA $117.72 $23.05 – $285.78 77,521 24
Cleveland, MS $137.41 $19.57 – $158.70 77,569 6
Richmond Heights, OH $82.86 $1.25 – $132.60 77,751 14
Oak Ridge, TN $107.06 $0.00 – $195.11 77,770 18
Mandeville, LA $107.25 $32.38 – $165.06 77,841 17
Galax, VA $119.58 $50.08 – $138.63 77,880 7
Bethpage, NY $94.80 $58.15 – $152.22 77,960 13
Wytheville, VA $126.71 $53.74 – $144.98 78,486 7
Greensburg, PA $89.28 $44.84 – $373.08 78,502 23
Fort Mohave, AZ $180.79 $60.97 – $222.40 78,579 9
Glens Falls, NY $112.05 $11.88 – $124.19 78,866 20
Beavercreek, OH $109.97 $33.07 – $171.60 79,314 24

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.