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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
Oberlin, OH $90.07 $45.12 – $141.24 122,039 13
Hyannis, MA $127.55 $33.95 – $233.57 122,041 46
Temecula, CA $68.16 $0.06 – $122.25 122,125 28
Clearwater, FL $68.14 $0.00 – $159.09 122,364 82
Sarasota, FL $68.25 $5.58 – $231.20 122,368 120
Cookeville, TN $81.19 $31.79 – $249.55 122,449 46
Mayfield, KY $137.80 $38.70 – $185.46 122,464 13
Terrytown, LA $106.27 $31.70 – $434.96 122,881 32
Woodland, CA $94.10 $0.00 – $913.00 122,917 18
Covina, CA $58.12 $34.15 – $100.96 122,922 15
Idaho Falls, ID $117.85 $39.71 – $177.78 122,984 24
Burlington, VT $56.39 $0.00 – $406.71 123,025 108
Oshkosh, WI $55.31 $20.19 – $168.62 124,172 32
Martinsville, VA $111.38 $48.72 – $155.82 124,271 16
Beloit, WI $57.49 $11.87 – $62.06 124,331 21
Aberdeen, WA $157.02 $61.96 – $182.62 124,589 8
Aiea, HI $336.11 $0.00 – $503.44 124,728 17
Englewood, NJ $126.34 $32.69 – $191.29 124,878 37
Columbus, GA $66.05 $0.00 – $140.14 125,376 58
Hialeah, FL $61.88 $0.00 – $332.10 125,429 63
Greenwood, MS $102.06 $14.22 – $129.65 125,793 26
Lexington, TN $78.42 $36.66 – $225.48 125,842 13
Wauwatosa, WI $43.46 $13.51 – $83.84 125,870 54
Newburgh, NY $127.06 $28.13 – $168.32 125,900 23
Palmer, MA $108.27 $16.76 – $173.47 125,922 22
St George, UT $70.79 $0.00 – $206.10 126,098 38
Marion, OH $90.84 $22.92 – $124.30 126,221 24
Bolivia, NC $118.52 $54.29 – $159.65 126,335 21
Bowling Green, OH $82.58 $40.70 – $152.16 126,350 26
Holland, MI $115.14 $48.28 – $182.68 126,522 4
Lebanon, OR $163.77 $26.87 – $207.66 126,970 24
Winter Haven, FL $70.39 $0.00 – $160.44 127,135 34
Wichita Falls, TX $116.22 $0.00 – $306.08 127,475 41
Redlands, CA $71.75 $2.10 – $127.46 127,798 31
Bellflower, CA $67.99 $0.00 – $205.98 127,893 36
College Station, TX $119.80 $0.20 – $297.56 128,210 63
Clearlake, CA $105.82 $0.00 – $710.71 128,311 21
Hayward, CA $54.30 $25.92 – $114.06 128,479 23
Manhattan Beach, CA $61.44 $11.50 – $109.54 128,569 28
Owosso, MI $116.73 $44.32 – $170.55 128,615 5
Baldwin Park, CA $276.35 $2.23 – $399.29 128,994 30
Espanola, NM $151.28 $63.63 – $177.49 129,106 16
Oxford, MS $120.59 $10.73 – $299.71 129,348 26
Coldwater, MI $93.47 $21.82 – $147.29 129,493 7
Elmira, NY $96.28 $22.51 – $181.90 129,701 35
Bayamon, PR $52.66 $0.00 – $337.39 130,431 78
Big Stone Gap, VA $124.83 $0.00 – $146.47 130,643 13
Plano, TX $138.94 $23.18 – $297.43 130,721 69
Hazel Crest, IL $72.86 $30.40 – $167.56 130,863 39
Opelousas, LA $82.19 $46.72 – $262.74 130,866 31

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.