Skip to content
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
Jackson, KY $159.82 $13.14 – $212.06 130,882 6
Florence, AL $57.51 $0.00 – $107.66 130,915 35
Cape May Court House, NJ $192.94 $31.72 – $261.12 131,067 14
Arlington, VA $134.76 $46.68 – $168.61 131,100 46
Greer, SC $40.62 $16.23 – $96.18 131,314 12
Mission, TX $146.80 $30.42 – $289.30 131,388 23
Maywood, IL $78.84 $14.60 – $186.21 131,766 87
Boulder, CO $96.18 $0.00 – $175.21 132,331 44
Hobart, IN $106.05 $53.36 – $207.01 132,661 14
Cape Girardeau, MO $99.47 $4.16 – $999.47 132,806 65
Folsom, CA $101.51 $6.64 – $185.32 132,874 36
Concord, NH $99.44 $0.00 – $240.26 133,241 59
Bend, OR $86.52 $0.00 – $1,611 133,384 75
Manassas, VA $204.83 $16.63 – $256.48 133,713 31
Provo, UT $63.83 $32.58 – $144.00 133,845 48
Florence, KY $220.04 $41.58 – $246.45 133,893 13
Petoskey, MI $104.07 $56.39 – $148.68 134,210 7
Elgin, IL $65.86 $15.43 – $138.47 134,276 50
Cleveland, TN $88.19 $18.02 – $342.57 134,309 29
Holyoke, MA $152.02 $7.11 – $181.95 134,354 19
Salisbury, NC $108.64 $36.55 – $184.74 134,536 29
Panama City, FL $80.84 $0.00 – $190.74 134,870 68
Hopkinsville, KY $112.13 $32.74 – $132.53 135,129 7
Loris, SC $51.92 $36.77 – $116.69 135,458 6
Newport Beach, CA $59.27 $0.36 – $156.84 135,511 48
Chico, CA $62.28 $0.05 – $776.21 135,596 33
Wayne, MI $212.00 $38.79 – $222.25 136,004 6
Olive Branch, MS $110.49 $24.15 – $150.99 136,502 16
Troy, MI $283.13 $31.29 – $300.10 136,526 11
Hilo, HI $270.52 $66.00 – $296.16 136,740 11
Skowhegan, ME $18.50 $15.49 – $69.10 136,775 16
Jamestown, NY $133.90 $0.00 – $436.87 136,969 21
Winchester, KY $189.93 $36.35 – $212.26 137,085 12
Moore, OK $137.03 $37.11 – $191.77 137,177 32
Tarzana, CA $55.35 $20.55 – $207.18 137,311 28
Sun City West, AZ $181.45 $51.60 – $240.91 137,962 37
Norton, VA $91.40 $24.44 – $199.35 138,128 21
Jeffersonville, IN $95.07 $19.97 – $253.39 138,300 27
Georgetown, KY $136.80 $45.51 – $184.17 138,532 15
Oak Park, IL $68.69 $22.89 – $139.54 139,279 44
Hudson, OH $85.30 $30.81 – $199.60 139,366 22
Lancaster, OH $86.82 $31.58 – $119.94 139,499 32
Williamsport, PA $77.43 $1.80 – $156.50 139,701 33
Hillsboro, OR $163.85 $6.12 – $352.94 139,746 37
Edmonds, WA $87.36 $58.95 – $106.86 139,908 21
Kennewick, WA $87.44 $32.30 – $148.49 140,080 20
Show Low, AZ $187.35 $10.77 – $239.15 140,101 28
Frankfort, KY $173.35 $22.11 – $231.72 140,227 14
Vincennes, IN $89.87 $26.08 – $105.16 140,802 20
Aiken, SC $47.39 $33.34 – $161.25 141,007 13

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.