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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
South Bend, IN $95.59 $15.16 – $201.70 180,378 53
Mccomb, MS $107.22 $7.34 – $146.51 181,110 25
Escondido, CA $199.96 $36.63 – $1,032 182,324 35
Dothan, AL $53.08 $0.00 – $136.56 182,523 55
Ogden, UT $48.92 $24.52 – $156.51 182,939 46
New Bern, NC $104.92 $0.00 – $363.83 183,032 35
Hickory, NC $109.35 $49.75 – $219.75 183,410 61
Yonkers, NY $165.27 $12.33 – $230.37 184,296 48
Burlington, NC $123.48 $0.00 – $256.19 185,726 49
Rock Hill, SC $43.04 $25.16 – $166.23 185,783 28
Miami Beach, FL $71.70 $13.02 – $217.13 185,812 76
Northridge, CA $71.38 $3.73 – $172.01 186,002 38
Mount Holly, NJ $249.21 $24.54 – $365.45 186,337 25
Bay Shore, NY $141.76 $38.54 – $208.50 186,421 44
Clinton Township, MI $75.94 $30.43 – $147.69 186,506 38
Casa Grande, AZ $214.62 $65.93 – $272.49 186,565 25
Van Nuys, CA $52.80 $15.99 – $128.38 186,817 28
Richmond Hill, NY $187.49 $28.70 – $270.48 186,899 26
Great Falls, MT $48.59 $10.02 – $205.00 187,468 52
New Albany, IN $103.77 $13.29 – $274.58 187,488 31
Boynton Beach, FL $85.46 $0.00 – $289.20 187,990 49
Monterey, CA $81.64 $1.46 – $157.17 188,389 36
Santa Maria, CA $58.29 $0.00 – $199.09 188,411 45
Corona, CA $69.87 $6.90 – $167.77 189,546 34
Utica, NY $214.25 $49.23 – $368.26 190,597 37
Flagstaff, AZ $212.77 $33.93 – $291.31 190,695 57
Aventura, FL $68.78 $0.00 – $251.51 191,707 65
Suffolk, VA $148.34 $46.03 – $156.48 191,952 18
Somers Point, NJ $192.65 $23.50 – $321.75 192,447 16
Fremont, CA $96.52 $0.00 – $326.86 192,926 45
Redmond, OR $92.20 $38.96 – $267.66 193,752 65
Palmdale, CA $94.04 $0.00 – $155.48 193,943 23
Edinburg, TX $249.60 $0.00 – $477.40 194,012 73
Terre Haute, IN $94.04 $18.48 – $271.01 194,040 55
Laredo, TX $166.58 $0.00 – $425.85 194,210 49
Auburn, WA $86.16 $0.00 – $184.14 194,256 33
Woodbury, NJ $167.85 $21.47 – $329.38 195,989 33
Murray, UT $53.79 $21.04 – $250.50 196,098 98
Federal Way, WA $84.90 $32.99 – $149.87 196,728 32
Mechanicsville, VA $125.31 $23.50 – $169.61 197,980 40
Silverdale, WA $94.64 $28.78 – $116.42 199,054 20
Longview, WA $91.97 $56.24 – $218.09 199,138 25
Middletown, NY $124.41 $4.60 – $184.00 199,236 77
Newark, OH $88.13 $26.12 – $176.82 199,270 47
La Crosse, WI $54.64 $17.06 – $216.66 200,060 103
Sioux City, IA $138.20 $0.00 – $2,275 200,767 58
Davenport, IA $125.92 $8.21 – $1,143 201,327 51
Maitland, FL $68.70 $8.36 – $242.26 201,609 46
Hazard, KY $183.78 $32.66 – $349.99 201,972 28
Lawton, OK $161.04 $55.30 – $201.44 202,594 50

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.