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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
Jackson, TN $94.97 $0.00 – $434.33 594,012 144
Monroe, LA $96.41 $11.45 – $317.03 600,206 108
New Hyde Park, NY $158.57 $33.00 – $679.71 601,883 176
Charleston, WV $127.35 $20.22 – $656.45 605,148 137
Redding, CA $123.87 $0.00 – $826.26 610,646 133
Vancouver, WA $93.61 $31.06 – $360.89 611,712 104
Virginia Beach, VA $112.32 $30.25 – $329.32 613,621 166
Jersey City, NJ $258.37 $16.88 – $402.20 617,176 89
Hollywood, FL $75.37 $0.00 – $329.12 617,968 151
Modesto, CA $82.65 $0.00 – $173.27 624,564 123
Greensboro, NC $138.22 $0.00 – $658.90 627,113 200
Bloomington, MN $158.22 $12.61 – $396.26 628,191 229
Allentown, PA $120.90 $0.00 – $515.70 630,031 208
New Brunswick, NJ $217.38 $18.90 – $415.85 637,604 115
Ann Arbor, MI $133.47 $0.00 – $343.50 642,800 118
Wichita, KS $61.55 $7.43 – $301.43 656,776 238
Austin, TX $125.71 $0.00 – $1,136 658,275 385
Mobile, AL $71.66 $0.00 – $291.73 658,803 229
Yakima, WA $82.45 $29.25 – $215.44 668,237 75
Waterbury, CT $205.52 $0.00 – $315.59 669,710 98
Corpus Christi, TX $141.12 $0.00 – $356.76 697,472 228
Des Moines, IA $135.04 $11.60 – $1,751 702,067 223
Salinas, CA $85.58 $8.29 – $167.46 703,028 75
Fayetteville, NC $99.27 $4.72 – $579.26 726,176 170
Madison, WI $59.96 $9.09 – $346.16 734,593 263
Canton, OH $90.78 $6.84 – $251.00 740,307 145
Colorado Springs, CO $100.38 $0.00 – $289.91 748,042 274
Gainesville, FL $81.28 $0.00 – $454.12 751,230 336
Worcester, MA $101.48 $0.00 – $254.29 753,637 356
Providence, RI $92.98 $20.94 – $680.08 754,000 367
Little Rock, AR $76.73 $1.79 – $227.51 756,433 280
Chattanooga, TN $109.38 $0.00 – $429.12 767,302 226
Glendale, AZ $215.01 $9.47 – $322.50 769,456 103
Colton, CA $73.91 $6.15 – $435.56 773,559 158
Anchorage, AK $225.47 $0.00 – $457.51 774,379 149
Flint, MI $131.38 $26.80 – $190.89 778,751 30
Greenville, NC $107.71 $16.53 – $1,091 785,186 213
Loma Linda, CA $195.45 $14.64 – $804.84 795,786 249
Omaha, NE $105.42 $0.00 – $1,094 797,205 294
Dearborn, MI $118.18 $28.74 – $266.41 797,255 27
Torrance, CA $60.39 $5.44 – $276.97 801,523 239
Bridgeport, CT $256.71 $8.89 – $393.87 810,081 133
Syracuse, NY $125.62 $6.84 – $1,381 815,459 239
Royal Oak, MI $126.55 $18.98 – $301.50 821,371 45
Saginaw, MI $129.09 $0.00 – $428.82 846,833 64
Paterson, NJ $222.35 $5.78 – $327.33 847,120 104
Honolulu, HI $340.33 $0.42 – $630.04 850,913 229
Falls Church, VA $120.18 $20.35 – $285.23 862,078 132
San Francisco, CA $99.86 $0.00 – $538.38 864,304 454
Orange, CA $91.53 $0.02 – $342.95 892,554 267

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.