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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
Coral Springs, FL $82.53 $0.00 – $285.96 101,863 52
Phillipsburg, NJ $265.62 $32.13 – $358.79 101,867 7
Rahway, NJ $178.74 $26.00 – $221.54 101,969 20
Leitchfield, KY $142.45 $26.81 – $199.32 102,155 9
Lodi, CA $66.50 $9.81 – $128.22 102,429 23
Coeur D Alene, ID $75.69 $34.41 – $173.47 102,696 51
Ardmore, OK $153.02 $56.18 – $180.04 102,812 20
Nogales, AZ $251.21 $24.80 – $394.28 103,283 15
Lakewood, NJ $275.72 $31.92 – $373.84 103,454 22
Hammond, IN $77.94 $26.70 – $105.08 103,729 22
Kenner, LA $114.92 $51.18 – $212.89 103,869 32
Franklin, OH $96.59 $34.16 – $137.80 103,990 13
Harvey, IL $58.66 $34.64 – $102.83 104,199 22
Annapolis, MD $85.03 $0.00 – $206.55 104,255 55
Marietta, GA $107.49 $10.66 – $528.44 104,415 60
Clare, MI $110.33 $57.50 – $153.19 104,503 3
The Woodlands, TX $137.28 $32.99 – $468.07 104,621 48
Marysville, CA $67.96 $0.00 – $876.53 104,663 34
Kokomo, IN $99.17 $8.31 – $178.94 104,685 29
Lakeport, CA $221.54 $0.00 – $730.48 104,687 17
Burlington, MA $129.97 $5.13 – $212.26 104,721 86
Tracy, CA $64.60 $17.43 – $132.29 104,741 15
Farmville, VA $131.92 $36.67 – $145.71 104,828 10
Orange Park, FL $75.68 $18.62 – $169.47 105,510 46
Southbridge, MA $140.99 $27.22 – $169.48 105,545 23
Dubuque, IA $121.29 $24.47 – $234.47 105,556 27
Carrollton, GA $69.98 $4.29 – $115.32 105,719 35
Mankato, MN $211.84 $22.93 – $1,085 105,745 61
Shelton, WA $244.13 $54.49 – $339.07 105,856 9
Cottonwood, AZ $160.40 $37.26 – $224.41 105,952 20
South Hill, VA $163.84 $23.55 – $227.51 106,165 16
South Boston, VA $110.99 $18.51 – $133.68 106,244 15
Franklin, TN $96.27 $33.27 – $182.44 106,621 31
Culpeper, VA $202.07 $38.91 – $232.78 106,692 18
Kingston, NY $101.57 $19.64 – $234.62 106,755 23
Passaic, NJ $193.49 $6.75 – $270.64 106,833 19
Waukesha, WI $47.70 $17.46 – $330.03 106,864 21
Newport, OR $139.44 $31.70 – $213.22 106,877 15
Mullins, SC $44.57 $31.24 – $65.71 106,901 12
Hartsville, SC $35.60 $23.55 – $85.54 107,057 9
Durant, OK $139.16 $67.51 – $206.32 107,142 30
Nyack, NY $122.63 $9.67 – $158.46 107,451 15
Silverton, OR $153.65 $71.80 – $175.14 107,528 11
Pulaski, VA $111.46 $52.70 – $153.77 107,680 10
Gallup, NM $166.21 $9.95 – $219.09 107,683 22
Massillon, OH $80.81 $0.00 – $217.26 107,735 19
Clovis, CA $17.09 $1.02 – $333.88 107,857 23
Poplar Bluff, MO $108.69 $31.56 – $448.51 108,016 27
Cullman, AL $54.81 $21.92 – $193.90 108,416 26
Corinth, MS $104.47 $27.21 – $175.57 108,626 33

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.