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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
Augusta, ME $128.80 $10.07 – $342.00 168,482 36
Thibodaux, LA $76.98 $31.46 – $401.92 168,827 31
Mount Vernon, WA $97.48 $0.00 – $133.84 169,367 26
Napa, CA $90.93 $0.00 – $933.97 169,696 40
Duluth, MN $151.89 $33.30 – $1,651 169,721 101
Walla Walla, WA $80.00 $35.22 – $144.27 169,738 22
Spokane Valley, WA $84.22 $0.00 – $369.36 170,517 24
Amarillo, TX $138.27 $8.25 – $876.03 170,747 84
Adrian, MI $95.01 $56.21 – $156.72 170,753 7
Biddeford, ME $127.05 $26.62 – $177.08 170,953 51
Emeryville, CA $63.24 $0.00 – $182.08 171,513 47
Anderson, SC $48.88 $0.00 – $261.62 171,679 49
Avon, IN $116.74 $0.00 – $233.24 171,821 46
Eau Claire, WI $55.46 $0.00 – $486.35 172,380 95
Chino, CA $61.70 $7.07 – $84.68 172,727 21
Council Bluffs, IA $115.88 $15.88 – $863.03 172,860 38
Rapid City, SD $76.07 $9.54 – $402.81 172,907 45
Williamsville, NY $99.33 $25.64 – $177.87 173,209 54
Brick, NJ $201.57 $4.95 – $311.26 173,369 28
Jonesboro, AR $64.86 $3.85 – $364.45 173,452 77
West Hills, CA $55.27 $0.00 – $117.00 173,638 46
Cuyahoga Falls, OH $86.00 $36.52 – $129.48 173,738 24
Lorain, OH $85.32 $4.65 – $115.70 173,745 33
West Covina, CA $46.31 $0.00 – $121.02 173,869 26
Grand Junction, CO $94.29 $10.55 – $167.39 174,201 57
Greenwood, SC $48.26 $28.18 – $430.17 174,432 43
Greenville, MS $92.45 $2.55 – $122.65 174,672 27
Munster, IN $101.32 $31.50 – $201.36 175,187 59
Henderson, KY $159.57 $22.72 – $274.71 175,345 17
Elmhurst, IL $69.11 $28.44 – $130.26 175,398 39
Marion, IN $93.56 $42.23 – $233.33 175,596 24
East Meadow, NY $110.54 $2.59 – $1,135 175,706 60
Sandusky, OH $84.02 $52.87 – $194.50 175,771 31
Savannah, GA $64.19 $14.22 – $814.86 176,153 74
Beaumont, TX $134.47 $2.59 – $554.87 176,309 56
Harrisonburg, VA $127.95 $41.30 – $152.21 176,693 22
Antioch, CA $88.53 $0.00 – $346.25 176,888 31
Norwalk, CT $211.47 $17.44 – $323.75 176,997 46
Springdale, AR $63.43 $1.15 – $163.44 177,040 43
Pittsfield, MA $163.41 $0.00 – $241.25 177,109 47
San Leandro, CA $189.34 $0.00 – $323.85 177,150 65
Methuen, MA $83.30 $36.82 – $250.90 177,704 23
Long Island City, NY $133.32 $37.67 – $149.72 177,877 26
Ft Lauderdale, FL $83.00 $0.00 – $208.21 178,196 59
Bethel, AK $122.45 $90.85 – $143.65 178,268 3
West Palm Beach, FL $76.33 $3.96 – $168.16 179,091 73
Johnstown, PA $91.08 $30.78 – $974.30 179,193 61
Monroe, MI $122.39 $47.30 – $193.72 179,511 33
Bossier City, LA $79.99 $31.93 – $375.69 179,637 32
Elyria, OH $92.22 $4.91 – $148.67 179,884 35

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.