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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
Hemet, CA $63.77 $37.81 – $204.39 259,128 22
Richmond, IN $98.35 $40.73 – $191.28 259,188 50
New Bedford, MA $153.25 $0.00 – $400.25 259,680 50
Elmhurst, NY $153.64 $24.39 – $199.90 259,838 65
Thornton, CO $101.39 $8.79 – $161.05 261,243 47
Janesville, WI $56.21 $9.96 – $114.43 261,364 55
Goodyear, AZ $163.57 $42.54 – $225.18 261,899 54
Shelby, NC $133.41 $31.57 – $181.52 262,166 45
Pembroke Pines, FL $63.95 $3.19 – $223.57 262,861 69
Ocala, FL $78.59 $2.45 – $235.43 264,757 120
Zanesville, OH $90.01 $37.17 – $172.54 265,227 50
Everett, WA $87.70 $24.45 – $215.65 265,284 89
Prescott, AZ $180.08 $0.00 – $246.77 266,458 39
Caguas, PR $47.91 $0.00 – $2,191 266,962 88
Tallahassee, FL $69.60 $4.54 – $191.40 267,878 116
Naperville, IL $61.44 $18.48 – $1,941 268,142 88
Pasadena, CA $59.25 $7.97 – $106.63 268,520 76
Danbury, CT $195.18 $11.89 – $313.03 268,934 60
Joplin, MO $137.40 $1.93 – $590.98 269,788 127
Salem, VA $142.73 $44.40 – $174.78 271,220 37
Kansas City, KS $91.32 $20.18 – $387.06 272,121 146
Medford, OR $140.40 $0.00 – $506.55 272,519 103
Topeka, KS $62.90 $23.14 – $416.98 272,908 94
Muncie, IN $121.04 $0.00 – $279.90 273,746 70
Lincoln, NE $91.86 $41.81 – $203.02 274,786 79
Pennington, NJ $246.65 $28.38 – $380.36 274,846 45
Fargo, ND $173.36 $29.37 – $494.88 275,570 90
Jackson, MI $149.03 $27.79 – $233.27 275,855 33
Rancho Mirage, CA $98.57 $56.22 – $413.33 276,235 79
Bellingham, WA $78.41 $0.23 – $149.39 276,417 52
La Mesa, CA $187.08 $54.16 – $516.15 277,381 48
Meridian, MS $112.70 $0.95 – $174.20 277,625 69
Danville, VA $115.81 $33.61 – $143.45 278,362 24
Wenatchee, WA $85.27 $29.63 – $162.68 279,046 48
Garden City, MI $126.39 $13.71 – $184.83 280,840 39
Danville, PA $91.85 $0.08 – $351.57 280,993 114
Meriden, CT $218.70 $0.07 – $328.63 281,483 37
Asheville, NC $114.56 $22.97 – $659.98 281,558 149
Reno, NV $82.82 $12.75 – $236.19 281,754 228
Fontana, CA $191.26 $0.00 – $548.82 282,136 66
Morristown, NJ $151.78 $16.70 – $292.63 282,140 101
Carolina, PR $58.06 $0.00 – $180.81 282,272 85
Corbin, KY $122.18 $33.06 – $178.23 282,359 26
Edison, NJ $201.48 $28.00 – $286.46 285,731 43
Mount Clemens, MI $150.30 $55.18 – $263.25 286,845 23
Chula Vista, CA $153.18 $0.00 – $405.72 289,725 43
Houma, LA $94.94 $24.71 – $281.78 290,477 64
Woodbridge, VA $132.60 $25.77 – $179.87 291,139 31
Chesapeake, VA $107.18 $31.04 – $196.95 291,240 61
Clarksville, TN $106.61 $7.45 – $409.15 291,469 60

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.