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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
Bridgeport, WV $143.56 $65.01 – $324.70 108,667 27
Yreka, CA $112.41 $0.00 – $130.63 108,687 15
Louisa, KY $141.78 $4.13 – $184.45 108,719 11
Philadelphia, MS $109.14 $21.11 – $148.59 108,860 23
Great Neck, NY $97.97 $23.65 – $118.24 108,966 12
Paintsville, KY $128.08 $51.33 – $163.50 109,164 9
Columbia, MD $101.51 $19.09 – $354.35 109,166 61
Waco, TX $111.38 $18.70 – $640.56 109,207 55
Washington, MO $137.38 $38.30 – $391.96 109,426 37
O Fallon, IL $80.52 $17.54 – $210.53 109,477 29
Maryville, TN $93.16 $6.71 – $134.46 109,711 31
National City, CA $67.41 $0.28 – $438.27 109,792 24
Greeley, CO $102.88 $0.00 – $175.73 109,847 29
Hillsdale, MI $107.75 $56.76 – $153.68 110,044 6
Fort Hood, TX $138.33 $43.69 – $358.57 110,061 37
Fond Du Lac, WI $46.88 $20.70 – $137.26 110,069 26
Ranson, WV $86.80 $53.16 – $171.09 110,271 11
Blacksburg, VA $121.97 $41.87 – $161.82 110,592 22
Irving, TX $117.79 $5.94 – $191.95 110,758 39
Wright Patterson Afb, OH $92.84 $33.63 – $171.68 110,948 26
Clinton, MD $142.98 $43.77 – $218.32 110,990 40
Dunn, NC $123.15 $42.72 – $237.17 111,005 16
Pleasanton, CA $59.54 $0.00 – $251.12 111,107 27
Helena, MT $58.38 $0.00 – $152.49 111,160 28
East Liverpool, OH $95.04 $1.02 – $156.41 111,217 24
Mchenry, IL $58.15 $21.37 – $160.52 111,254 46
Denville, NJ $235.35 $35.76 – $331.23 111,404 16
Minden, LA $79.76 $47.84 – $109.67 111,556 14
Ruidoso, NM $161.63 $55.96 – $266.55 111,752 14
Greenville, IL $74.59 $28.29 – $125.42 111,978 31
Framingham, MA $132.57 $35.56 – $211.51 112,323 30
Attleboro, MA $128.91 $25.49 – $154.33 112,692 21
Henderson, NC $101.00 $31.30 – $195.61 112,702 21
Selma, AL $67.11 $10.83 – $102.99 112,874 17
Davis, CA $93.18 $0.00 – $113.87 112,885 27
Fairfax, VA $146.50 $28.78 – $197.02 112,945 37
Odessa, TX $121.71 $6.63 – $1,635 112,959 51
Mishawaka, IN $111.42 $9.89 – $640.10 113,054 27
Overland Park, KS $86.21 $11.01 – $826.47 113,299 86
White Plains, NY $129.72 $20.49 – $173.21 113,308 36
South Weymouth, MA $176.93 $45.11 – $196.93 113,403 16
Santa Barbara, CA $37.95 $6.40 – $586.15 113,423 62
Humble, TX $167.01 $1.68 – $223.80 113,635 38
Natchez, MS $99.52 $19.94 – $327.81 113,934 14
Bradenton, FL $67.04 $9.62 – $626.41 113,958 68
Patchogue, NY $120.73 $28.04 – $158.74 114,359 25
Picayune, MS $123.83 $34.52 – $181.04 114,426 10
Maplewood, MN $178.20 $55.51 – $259.35 114,648 52
Hendersonville, TN $148.37 $0.00 – $433.04 114,731 26
Abingdon, VA $108.00 $0.00 – $294.20 114,975 34

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.