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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
Flowood, MS $93.47 $8.84 – $114.56 84,256 11
Lake Havasu City, AZ $150.14 $35.76 – $377.25 84,304 19
Redwood City, CA $92.98 $0.15 – $192.67 84,442 30
Montebello, CA $60.36 $21.98 – $107.80 84,570 14
Dillon, SC $32.58 $24.99 – $173.93 84,907 10
Laconia, NH $111.03 $8.50 – $163.03 84,953 31
Broken Arrow, OK $137.65 $71.77 – $196.22 85,006 17
Langhorne, PA $134.87 $28.08 – $316.37 85,020 28
Montclair, CA $73.46 $37.74 – $161.83 85,255 15
Asheboro, NC $146.21 $20.05 – $340.58 85,587 14
Front Royal, VA $138.13 $55.80 – $184.54 85,660 11
Emporia, VA $120.18 $46.82 – $159.32 85,787 8
Chester, SC $61.03 $31.34 – $158.39 85,792 10
Gig Harbor, WA $87.91 $58.90 – $93.58 85,941 15
Whiteville, NC $121.11 $53.90 – $210.77 86,134 15
Lawrenceburg, TN $65.40 $20.06 – $190.56 86,183 7
Campbellsville, KY $100.56 $21.99 – $120.20 86,190 10
Chester, PA $124.13 $0.74 – $247.38 86,311 37
Portland, IN $104.51 $58.62 – $109.78 86,389 8
Sierra Vista, AZ $211.06 $36.43 – $265.30 86,499 16
Gresham, OR $141.92 $2.76 – $285.08 86,688 22
Lake Forest, IL $72.26 $26.95 – $137.59 86,732 32
Hinsdale, IL $61.80 $32.39 – $95.89 86,822 27
Northport, AL $45.49 $16.71 – $96.49 87,107 15
Lebanon, KY $173.03 $59.68 – $243.33 87,131 4
Manning, SC $38.06 $28.36 – $77.85 87,152 13
Palo Alto, CA $68.30 $0.00 – $413.52 87,160 98
Murray, KY $154.61 $26.84 – $227.30 87,229 10
Hendersonville, NC $113.03 $17.90 – $187.05 87,381 47
Enterprise, AL $54.43 $23.94 – $133.03 87,395 18
Rochester, NH $84.44 $1.66 – $135.43 87,544 15
Grenada, MS $94.34 $26.04 – $118.42 87,691 12
Fort Sam Houston, TX $109.64 $22.84 – $252.29 87,848 62
Alabaster, AL $61.47 $0.00 – $95.74 87,877 18
Salina, KS $54.65 $27.54 – $154.55 88,176 23
Plattsburgh, NY $118.11 $15.05 – $180.78 88,317 26
Stevens Point, WI $50.53 $16.74 – $117.44 88,359 20
Weymouth, MA $70.58 $31.12 – $146.46 88,472 47
Buckhannon, WV $121.37 $67.42 – $267.89 88,504 14
Troy, OH $104.04 $37.08 – $155.07 88,506 18
Lanham, MD $129.97 $3.09 – $163.14 88,561 32
San Angelo, TX $94.66 $40.07 – $185.95 89,249 32
Durango, CO $110.93 $16.01 – $195.10 89,281 32
Holmdel, NJ $195.96 $13.91 – $287.34 89,298 15
Logan, WV $171.64 $7.02 – $468.70 89,522 16
Marquette, MI $113.23 $59.67 – $181.71 89,658 6
Prosper, TX $138.46 $43.75 – $553.66 89,749 21
South Williamson, KY $139.19 $43.18 – $178.10 89,919 9
Mason City, IA $114.20 $13.81 – $1,750 89,920 29
West Hollywood, CA $89.20 $0.00 – $270.14 90,011 76

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.