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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
Grants Pass, OR $129.21 $54.64 – $1,102 154,540 43
Warrensville Heights, OH $106.49 $34.74 – $150.82 155,098 22
Manchester, CT $131.43 $0.00 – $260.11 155,133 36
Bristol, TN $115.41 $17.01 – $151.14 155,283 30
Ypsilanti, MI $211.38 $27.81 – $500.84 155,402 19
Indio, CA $162.66 $31.05 – $263.97 155,794 10
Panorama City, CA $259.51 $0.00 – $476.01 156,721 34
Princeton, WV $122.81 $15.99 – $606.41 156,749 18
Midlothian, VA $147.07 $40.06 – $233.69 157,268 26
Franklin, VA $90.92 $47.81 – $502.29 157,596 11
Sumter, SC $38.43 $29.96 – $136.42 157,791 14
Southaven, MS $126.79 $20.76 – $157.80 158,505 34
Watsonville, CA $86.08 $21.78 – $166.99 158,516 13
Lapeer, MI $112.42 $73.08 – $194.28 158,752 2
Lancaster, SC $65.48 $6.04 – $160.60 159,664 22
Vicksburg, MS $110.62 $29.43 – $152.24 160,312 18
Banning, CA $70.56 $48.33 – $164.64 160,378 17
Lakewood, WA $82.63 $24.30 – $296.39 160,560 20
Pleasant Prairie, WI $60.11 $24.66 – $123.47 160,653 12
Clackamas, OR $171.70 $59.99 – $422.90 160,884 78
Berkeley, CA $72.88 $0.34 – $240.22 161,073 51
Bristol, CT $188.69 $0.00 – $229.89 161,192 16
Greenbrae, CA $96.74 $0.07 – $1,086 161,373 22
Fort Bragg, NC $93.62 $0.00 – $305.90 161,503 69
Sevierville, TN $116.03 $30.23 – $539.07 161,635 26
Los Banos, CA $72.18 $0.00 – $352.59 161,825 15
Evanston, IL $67.03 $29.71 – $281.05 162,622 94
Euclid, OH $100.75 $40.72 – $137.80 162,785 20
Burien, WA $84.04 $30.54 – $90.64 162,936 22
Ponce, PR $84.18 $0.00 – $340.17 162,937 106
Palmer, AK $215.99 $113.00 – $259.25 163,311 16
Bellevue, WA $74.33 $8.39 – $153.83 163,371 65
Glasgow, KY $130.60 $22.26 – $298.00 163,568 28
Moses Lake, WA $84.16 $26.60 – $232.63 164,008 25
Albany, GA $107.12 $42.05 – $118.68 164,421 29
Binghamton, NY $133.96 $42.84 – $154.04 164,441 13
Valhalla, NY $138.00 $24.41 – $331.11 164,878 55
Far Rockaway, NY $138.38 $13.37 – $224.61 164,900 37
West Reading, PA $98.99 $0.00 – $267.73 165,328 65
Kingwood, TX $135.02 $36.11 – $1,298 165,929 44
Tempe, AZ $128.85 $22.85 – $192.07 165,944 30
Morehead, KY $108.91 $26.17 – $384.56 166,037 39
Madisonville, KY $147.72 $34.24 – $242.44 166,082 21
Gallipolis, OH $100.16 $44.33 – $235.14 166,202 26
Grosse Pointe, MI $214.10 $44.62 – $250.93 166,329 11
Sun City, AZ $144.53 $51.50 – $287.31 167,274 39
Parkersburg, WV $125.55 $36.46 – $410.71 167,294 31
Salem, MA $116.60 $35.67 – $183.00 167,439 46
Atlantic City, NJ $48.62 $8.46 – $175.49 167,878 40
Harlingen, TX $124.90 $17.88 – $291.28 168,271 62

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.