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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
Kissimmee, FL $71.70 $1.14 – $203.22 225,016 97
Lumberton, NC $99.51 $29.41 – $250.77 225,559 63
Perth Amboy, NJ $198.04 $21.44 – $310.15 225,603 30
Neptune, NJ $224.45 $33.10 – $306.46 225,797 32
Goldsboro, NC $109.50 $3.49 – $230.80 226,739 51
Rockford, IL $69.98 $18.36 – $160.37 227,177 89
Upland, CA $69.32 $5.76 – $133.41 227,225 24
Ventura, CA $130.26 $0.00 – $1,187 227,642 58
Downey, CA $278.23 $15.92 – $498.77 229,221 38
Mansfield, OH $89.29 $26.41 – $182.54 229,267 43
Longview, TX $158.89 $10.93 – $941.67 230,150 69
Waterloo, IA $132.61 $8.43 – $1,445 230,395 60
Appleton, WI $51.76 $15.87 – $1,091 230,945 47
Fountain Valley, CA $66.13 $2.98 – $200.34 230,945 66
Leesburg, VA $142.73 $39.54 – $206.58 231,157 37
Winchester, VA $131.99 $12.89 – $304.15 231,446 69
Coral Gables, FL $100.21 $11.77 – $312.60 231,998 74
Lawrence, MA $67.42 $4.71 – $178.38 232,655 46
Orangeburg, SC $38.82 $23.90 – $144.14 232,756 29
Williamsburg, VA $107.16 $33.52 – $163.03 233,118 35
Missoula, MT $54.89 $2.55 – $325.70 233,927 40
Santa Cruz, CA $85.44 $0.14 – $172.38 235,236 34
Laurel, MS $110.27 $17.35 – $275.73 235,616 40
Minnetonka, MN $181.64 $58.27 – $242.95 236,111 76
Apple Valley, CA $67.13 $0.00 – $375.00 237,247 43
Boise, ID $79.68 $30.64 – $770.85 237,704 142
Hopewell, VA $154.36 $27.05 – $165.59 238,190 16
Lakewood, CO $98.39 $0.00 – $195.22 238,723 100
Westerville, OH $94.20 $19.84 – $188.66 239,848 52
Slidell, LA $93.45 $3.90 – $383.58 241,060 66
Beachwood, OH $90.69 $4.54 – $120.06 241,687 45
Stamford, CT $232.51 $19.14 – $334.24 241,827 57
Mission Hills, CA $67.92 $0.00 – $245.14 242,884 32
Carmichael, CA $111.02 $7.23 – $189.78 244,288 39
Bangor, ME $160.57 $14.72 – $307.76 245,511 72
Sunrise, FL $76.42 $27.02 – $350.28 246,555 55
Harrisburg, PA $86.13 $20.67 – $275.27 246,565 119
Chillicothe, OH $86.38 $41.28 – $159.22 247,843 46
Pascagoula, MS $107.94 $13.22 – $140.52 248,901 26
Merced, CA $84.49 $16.75 – $131.71 249,697 31
Columbus, MS $111.42 $19.56 – $140.75 250,035 27
Englewood, CO $95.08 $13.09 – $182.01 250,627 73
Beckley, WV $109.65 $0.00 – $503.77 250,956 36
Tuscaloosa, AL $45.22 $0.00 – $173.54 251,073 62
Lynwood, CA $75.25 $24.51 – $158.83 252,079 41
Middletown, CT $218.69 $9.44 – $276.59 254,571 40
Summit, NJ $189.96 $14.79 – $259.79 254,659 30
Melbourne, FL $68.06 $7.59 – $765.62 255,533 118
Fall River, MA $127.54 $34.33 – $195.42 256,274 78
Palm Springs, CA $145.06 $0.00 – $309.00 257,620 59

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.