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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
Petaluma, CA $66.28 $0.00 – $899.44 95,833 49
North Kansas City, MO $87.69 $14.52 – $469.30 95,873 46
Greenwich, CT $208.63 $24.82 – $292.63 96,373 19
Taylor, MI $236.71 $43.19 – $273.59 96,421 5
Brentwood, TN $80.17 $21.36 – $265.33 96,460 28
Reston, VA $138.67 $32.56 – $172.02 96,483 31
Forest Hills, NY $86.21 $20.86 – $178.78 96,498 41
Leominster, MA $143.57 $34.38 – $194.14 96,862 22
Smyrna, TN $131.91 $3.64 – $420.53 96,936 26
Fullerton, CA $68.74 $29.02 – $170.88 96,981 28
Santa Ana, CA $70.60 $0.00 – $191.90 97,095 50
Sanford, NC $111.03 $43.22 – $234.22 97,101 25
Dover, OH $78.68 $32.39 – $115.96 97,135 21
West Burlington, IA $118.62 $16.45 – $204.96 97,381 18
Kalispell, MT $64.81 $0.97 – $294.36 97,679 33
Germantown, MD $108.47 $29.02 – $513.08 97,681 56
Reedley, CA $27.46 $11.73 – $368.71 97,688 11
Bessemer, AL $75.44 $24.11 – $111.48 97,741 16
Laurinburg, NC $82.09 $31.16 – $192.51 97,758 17
Shawano, WI $160.35 $25.89 – $196.37 97,808 13
Jacksonville, NC $100.17 $2.31 – $192.09 98,021 40
Valley Stream, NY $126.89 $39.63 – $310.00 98,022 35
Covington, WA $114.43 $29.98 – $192.08 98,291 6
South Charleston, WV $104.71 $44.87 – $244.13 98,390 26
Norway, ME $14.21 $12.65 – $77.71 98,648 7
Northampton, MA $95.84 $22.05 – $200.18 98,711 34
Wildomar, CA $77.55 $11.58 – $297.73 98,772 15
Freehold, NJ $303.18 $19.34 – $427.28 98,837 29
East Boston, MA $86.63 $52.19 – $138.20 98,842 18
Chicago Heights, IL $82.02 $24.20 – $151.33 98,941 21
Saint Joseph, MO $128.77 $44.16 – $443.76 99,206 69
Kirkland, WA $77.60 $10.22 – $106.84 99,207 23
Wilmington, OH $81.92 $37.95 – $183.59 99,588 20
Manchester, KY $115.76 $36.00 – $136.71 99,597 8
Hamilton, NJ $156.15 $25.67 – $221.74 99,636 24
North Wilkesboro, NC $129.46 $43.29 – $232.15 99,974 28
Gadsden, AL $55.60 $16.50 – $137.74 100,040 28
Rock Island, IL $79.18 $14.19 – $197.03 100,171 32
Arlington Heights, IL $69.28 $30.02 – $208.19 100,309 38
Norwalk, OH $84.51 $7.18 – $113.41 100,320 14
Bozeman, MT $65.81 $2.52 – $266.72 100,630 42
Rocky Mount, NC $114.71 $0.20 – $252.29 100,682 29
Riverdale, GA $145.52 $32.22 – $163.48 100,767 12
Parma, OH $89.77 $0.00 – $259.14 100,792 29
Avon, OH $85.34 $42.50 – $104.41 100,898 15
Safford, AZ $146.68 $40.78 – $186.05 100,907 12
Summerville, SC $63.51 $22.35 – $247.08 101,171 22
Bullhead City, AZ $155.41 $1.37 – $178.53 101,344 12
Belleville, IL $70.22 $29.90 – $257.63 101,619 35
Gallatin, TN $100.84 $1.26 – $188.36 101,829 32

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.