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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
Brockton, MA $115.39 $37.12 – $303.75 356,318 103
Jamaica, NY $122.72 $20.25 – $208.60 357,918 136
Portland, ME $145.93 $0.00 – $423.16 357,964 135
Lima, OH $86.27 $0.83 – $203.20 360,245 79
Fairfield, CA $100.97 $0.00 – $955.72 361,307 44
Paducah, KY $127.86 $16.51 – $225.57 361,942 60
Owensboro, KY $152.85 $17.20 – $233.20 363,335 45
Salem, OR $130.21 $5.88 – $1,136 363,505 68
Elizabethtown, KY $136.45 $35.77 – $245.65 364,025 39
San Bernardino, CA $230.79 $0.00 – $434.17 364,892 46
Norwich, CT $218.59 $21.13 – $310.05 370,372 45
Huntsville, AL $63.85 $0.00 – $244.98 371,204 152
Alexandria, VA $158.85 $14.11 – $226.63 371,615 87
Visalia, CA $50.70 $8.10 – $158.70 373,478 84
Kingman, AZ $139.94 $49.11 – $289.92 374,322 59
Warren, OH $90.38 $0.75 – $138.70 374,417 45
Gulfport, MS $115.37 $15.37 – $586.04 376,171 61
Pontiac, MI $154.55 $43.89 – $182.10 376,602 31
Chandler, AZ $149.08 $44.53 – $361.86 378,683 108
Yuma, AZ $217.81 $8.67 – $284.59 379,026 53
Tyler, TX $103.85 $19.82 – $393.26 379,823 137
Pensacola, FL $71.86 $0.00 – $654.96 380,439 174
Concord, NC $136.67 $8.41 – $253.51 384,252 94
Puyallup, WA $96.92 $9.34 – $159.02 384,744 43
Norman, OK $150.13 $56.03 – $349.26 386,232 83
Hampton, VA $131.74 $16.79 – $206.61 387,050 43
Lafayette, IN $102.68 $30.28 – $213.65 388,358 92
Newport News, VA $133.31 $25.74 – $201.16 389,878 100
Renton, WA $74.96 $0.00 – $162.67 390,925 50
York, PA $105.26 $0.00 – $432.85 391,152 167
Bowling Green, KY $162.29 $24.17 – $260.00 391,973 50
Saint Paul, MN $164.20 $22.68 – $1,710 394,514 232
Cambridge, MA $130.28 $48.45 – $205.59 400,697 62
Rockville, MD $80.12 $22.50 – $314.43 400,930 75
Richland, WA $90.75 $0.00 – $136.91 401,634 60
Hershey, PA $130.02 $29.43 – $2,226 405,079 122
San Juan, PR $66.54 $0.00 – $570.77 406,486 253
Vallejo, CA $84.85 $0.00 – $966.31 409,509 77
Stanford, CA $105.79 $0.00 – $397.20 411,677 260
Laveen, AZ $221.20 $221.20 – $221.20 420,697 1
Anaheim, CA $82.43 $0.00 – $196.36 425,590 82
Evansville, IN $110.87 $22.29 – $389.96 429,741 138
Fort Myers, FL $84.41 $0.00 – $412.93 434,735 210
Marietta, OH $109.57 $34.09 – $188.50 437,828 79
Fort Collins, CO $97.56 $39.65 – $213.65 437,891 109
Farmington, NM $158.46 $37.87 – $213.65 439,282 51
Green Bay, WI $54.82 $17.35 – $182.56 440,979 92
Cedar Rapids, IA $123.45 $16.03 – $2,044 441,777 104
Alexandria, LA $70.53 $7.86 – $215.67 444,369 103
Hammond, LA $74.12 $0.00 – $324.25 445,615 68

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.