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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
Columbia, TN $106.56 $0.00 – $234.23 115,078 33
Quincy, IL $66.19 $2.09 – $157.70 115,154 34
Evergreen Park, IL $68.61 $34.05 – $148.18 115,323 19
Paris, TN $80.78 $25.59 – $136.96 115,550 20
Willingboro, NJ $252.75 $39.29 – $318.56 115,695 8
Valparaiso, IN $96.61 $14.58 – $145.01 115,868 21
Silver Spring, MD $125.73 $34.01 – $563.91 115,966 77
Hot Springs, AR $60.40 $9.70 – $148.66 116,030 52
Pasco, WA $170.07 $21.26 – $215.10 116,077 17
Bismarck, ND $179.72 $33.78 – $333.31 116,805 56
Delano, CA $198.08 $0.00 – $383.25 116,815 11
Ravenna, OH $88.75 $34.38 – $136.61 116,969 22
Teaneck, NJ $217.13 $29.60 – $263.76 117,095 18
Oceanside, NY $124.88 $28.64 – $182.88 117,109 42
Alamogordo, NM $183.08 $37.37 – $325.25 117,331 19
Alpena, MI $97.56 $58.19 – $183.73 117,680 6
Battle Creek, MI $151.73 $24.32 – $153.61 117,735 5
Altoona, PA $96.35 $48.99 – $158.98 117,922 30
Brawley, CA $84.34 $39.44 – $434.53 118,158 12
Sherman Oaks, CA $60.65 $11.50 – $184.08 118,496 38
Lebanon, PA $116.77 $0.00 – $270.00 118,548 34
Wausau, WI $47.55 $15.75 – $160.80 118,931 24
Manistee, MI $85.55 $58.05 – $150.40 118,938 4
Monterey Park, CA $89.98 $0.00 – $328.77 118,990 38
Delaware, OH $80.45 $55.47 – $130.41 119,099 18
Bartlett, TN $95.53 $2.00 – $184.13 119,107 23
Hagerstown, MD $112.51 $32.46 – $222.85 119,319 46
Walterboro, SC $55.68 $12.51 – $95.83 119,366 10
East Orange, NJ $191.23 $23.03 – $222.82 119,485 17
Hillsboro, OH $92.09 $7.73 – $351.50 119,507 17
Martinsburg, WV $125.16 $43.65 – $417.16 119,616 24
Plantation, FL $73.01 $0.00 – $248.79 119,828 63
Menomonee Falls, WI $53.39 $14.53 – $88.19 119,875 22
Manahawkin, NJ $215.76 $24.62 – $321.16 119,987 17
West Allis, WI $59.52 $23.43 – $135.12 120,267 16
Wailuku, HI $390.79 $6.96 – $509.70 120,290 29
Hamilton, OH $93.92 $46.43 – $123.95 120,353 19
Texarkana, TX $112.65 $32.71 – $596.94 120,387 43
Gardena, CA $64.49 $38.53 – $290.44 120,685 20
Camden, SC $71.66 $29.95 – $149.79 120,792 14
Monroe, NC $86.44 $22.53 – $167.46 120,795 42
Macon, GA $79.62 $0.00 – $252.51 120,832 95
Batavia, OH $93.23 $33.39 – $137.55 121,043 25
French Camp, CA $80.06 $4.34 – $136.99 121,219 27
Pine Bluff, AR $63.97 $32.57 – $204.56 121,243 39
Danville, IN $116.24 $27.36 – $177.45 121,253 33
Beaufort, SC $41.76 $19.55 – $173.18 121,314 21
Round Rock, TX $102.87 $0.00 – $634.50 121,395 83
Bay City, MI $153.28 $48.26 – $168.22 121,432 9
New Albany, MS $125.62 $22.70 – $153.53 121,901 14

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.