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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
Glendora, CA $61.31 $22.50 – $81.61 141,130 16
Roseburg, OR $122.45 $56.44 – $770.57 141,697 38
La Jolla, CA $75.86 $18.01 – $344.22 141,788 69
Pasadena, TX $168.39 $0.43 – $1,310 142,654 56
Derby, CT $257.91 $11.85 – $332.92 143,485 23
Arlington, TX $105.22 $0.00 – $760.25 143,585 78
New Rochelle, NY $93.75 $20.91 – $153.38 143,662 18
Eugene, OR $141.50 $5.61 – $574.47 143,888 37
Trenton, MI $159.99 $35.34 – $263.13 143,925 22
Morristown, TN $113.43 $13.79 – $254.81 144,306 27
Brownsville, TX $119.39 $0.22 – $390.11 144,528 54
Park Ridge, IL $58.49 $24.60 – $201.66 144,532 79
Sheboygan, WI $52.42 $12.67 – $226.02 144,586 29
Montclair, NJ $236.11 $31.35 – $392.91 144,725 27
Camp Lejeune, NC $105.52 $0.00 – $201.16 144,924 33
Albany, OR $152.05 $26.20 – $449.74 144,955 33
Schenectady, NY $101.76 $4.53 – $147.79 145,697 53
Gary, IN $104.80 $48.42 – $179.23 145,760 27
Biloxi, MS $104.80 $21.92 – $169.50 146,810 25
Long Branch, NJ $280.47 $26.00 – $380.39 147,676 23
Conway, SC $38.64 $27.32 – $203.83 148,290 17
Decatur, GA $119.94 $19.69 – $137.30 148,510 39
Deland, FL $88.91 $15.72 – $142.32 148,681 29
Port St Lucie, FL $73.21 $6.68 – $333.74 148,710 51
Aurora, IL $61.67 $32.20 – $160.43 148,898 37
Fairbanks, AK $324.63 $57.65 – $452.99 149,535 25
Myrlte Beach, SC $57.67 $57.67 – $57.67 150,141 1
Joliet, IL $77.12 $24.17 – $151.62 150,445 49
Lancaster, PA $85.60 $0.00 – $638.95 150,561 61
Warwick, RI $101.75 $0.00 – $301.78 150,623 79
Hanford, CA $25.74 $5.83 – $185.74 150,763 22
Centralia, WA $88.25 $49.68 – $141.65 151,632 19
Richmond, KY $158.07 $44.05 – $205.00 151,769 7
Brookhaven, MS $107.22 $7.52 – $138.74 152,011 24
Oxnard, CA $113.16 $0.43 – $278.90 152,027 40
Germantown, TN $102.60 $0.00 – $367.06 152,110 53
Decatur, IL $61.57 $24.24 – $379.80 152,348 38
Naples, FL $88.35 $24.92 – $1,015 152,413 93
Selma, CA $13.45 $1.96 – $65.45 152,417 16
Alma, MI $113.15 $63.17 – $162.90 152,504 4
Carbondale, IL $61.27 $26.27 – $212.66 152,544 52
San Pedro, CA $61.11 $0.00 – $117.34 152,642 21
Nashua, NH $88.02 $29.57 – $160.27 153,287 37
Mineola, NY $130.35 $23.59 – $409.33 153,504 57
Fort Lauderdale, FL $77.87 $3.37 – $242.05 153,587 78
Castro Valley, CA $118.75 $12.97 – $199.45 154,266 28
Burbank, CA $60.04 $0.00 – $249.89 154,272 39
Kenosha, WI $52.98 $18.32 – $84.90 154,321 37
Wheat Ridge, CO $96.51 $49.77 – $203.51 154,418 46
Torrington, CT $252.82 $10.13 – $362.16 154,420 24

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.