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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
Columbia, MO $139.18 $22.36 – $542.23 446,955 229
Florence, SC $55.47 $20.33 – $195.94 447,850 83
Durham, NC $105.90 $0.00 – $533.96 448,598 242
Las Cruces, NM $136.82 $2.54 – $323.84 452,007 72
Pueblo, CO $95.35 $0.00 – $225.78 452,056 86
Chapel Hill, NC $120.58 $20.11 – $366.23 452,177 207
Montgomery, AL $56.31 $0.00 – $130.30 458,036 133
Augusta, GA $86.72 $22.14 – $217.51 458,179 196
Saint Joseph, MI $115.50 $0.00 – $271.49 466,205 39
Farmington Hills, MI $126.96 $35.85 – $246.46 467,772 45
Billings, MT $62.18 $0.00 – $248.74 468,707 69
Metairie, LA $102.44 $0.00 – $401.98 469,812 71
Scottsdale, AZ $153.07 $13.34 – $267.27 470,418 197
Hattiesburg, MS $121.47 $7.37 – $286.08 475,588 94
Huntington, WV $107.13 $29.32 – $591.60 476,090 103
Spartanburg, SC $59.48 $28.59 – $177.14 484,153 108
Wyandotte, MI $127.92 $20.04 – $262.79 484,509 38
Newport, TN $72.28 $36.69 – $135.76 484,892 13
Lynchburg, VA $108.68 $13.07 – $160.13 486,853 98
Flushing, NY $116.06 $14.86 – $795.71 487,528 135
Long Beach, CA $66.90 $0.00 – $335.38 488,108 112
Springfield, IL $69.78 $18.10 – $432.50 490,116 171
Albany, NY $100.90 $7.46 – $208.80 490,144 168
Madera, CA $40.89 $0.00 – $492.58 493,699 58
Santa Rosa, CA $93.87 $0.00 – $910.70 505,118 161
Springfield, MO $135.19 $9.43 – $707.57 508,754 223
Wilmington, NC $138.32 $0.00 – $401.38 511,613 108
Vineland, NJ $291.26 $22.62 – $485.17 511,617 53
Edgewood, KY $152.51 $30.35 – $253.55 512,114 82
St Petersburg, FL $102.37 $1.35 – $681.43 514,976 154
Oak Lawn, IL $74.58 $9.42 – $318.76 520,722 211
Fredericksburg, VA $130.54 $29.21 – $182.79 532,656 69
Staten Island, NY $136.33 $19.73 – $242.31 532,721 181
San Jose, CA $55.85 $0.00 – $577.83 533,312 191
Muskegon, MI $105.47 $29.67 – $170.02 535,424 23
Morgantown, WV $113.42 $25.24 – $494.01 545,130 158
Southfield, MI $68.59 $15.24 – $176.90 552,834 21
Livonia, MI $83.82 $29.59 – $263.45 555,726 29
Lake Charles, LA $92.64 $8.73 – $390.99 559,407 101
Newark, DE $90.00 $5.25 – $285.02 560,932 182
Peoria, IL $74.72 $29.72 – $1,130 561,795 161
Temple, TX $124.56 $0.00 – $319.80 563,081 202
Charlottesville, VA $131.46 $10.65 – $242.07 564,756 185
Roanoke, VA $113.17 $21.30 – $304.22 568,599 183
Voorhees, NJ $266.28 $14.85 – $386.48 572,433 59
New Britain, CT $195.43 $27.46 – $297.56 575,423 58
Lancaster, CA $253.08 $16.88 – $466.72 577,590 55
Hackensack, NJ $188.15 $15.62 – $332.38 581,932 199
Erie, PA $80.44 $0.00 – $244.50 582,207 159
Stratford, NJ $246.41 $19.39 – $413.79 592,937 78

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.