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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
Salt Lake City, UT $74.59 $16.07 – $612.92 909,018 289
Raleigh, NC $139.82 $0.00 – $508.66 911,865 230
Spokane, WA $83.78 $0.00 – $363.51 932,048 183
Springfield, MA $119.65 $8.58 – $406.33 960,403 252
Kettering, OH $92.55 $17.52 – $227.08 963,000 210
El Paso, TX $138.81 $0.00 – $579.72 968,153 286
Camden, NJ $221.85 $19.21 – $572.38 991,480 223
Mesa, AZ $212.76 $8.66 – $348.21 1,012,467 174
Fresno, CA $38.60 $0.00 – $689.65 1,035,563 315
Minneapolis, MN $208.05 $19.21 – $1,683 1,046,400 441
Winston Salem, NC $152.58 $0.00 – $1,070 1,052,025 315
Bethlehem, PA $100.74 $10.73 – $568.31 1,060,730 269
Greenville, SC $67.16 $0.00 – $622.02 1,080,286 421
Buffalo, NY $120.86 $0.00 – $406.99 1,082,052 327
Lafayette, LA $84.94 $14.79 – $297.74 1,082,809 202
Denver, CO $97.09 $0.00 – $679.38 1,116,435 447
Tulsa, OK $146.56 $18.73 – $1,174 1,133,029 457
Kalamazoo, MI $95.58 $14.25 – $312.83 1,136,532 92
Oakland, CA $83.54 $0.00 – $739.45 1,142,476 332
Tacoma, WA $97.44 $10.77 – $312.18 1,146,159 250
Kansas City, MO $140.53 $0.00 – $969.10 1,170,483 482
Fort Wayne, IN $106.03 $11.84 – $1,265 1,181,321 230
Columbia, SC $72.77 $11.70 – $442.94 1,188,627 275
Jacksonville, FL $81.49 $2.29 – $1,442 1,193,809 546
Tampa, FL $73.51 $0.00 – $355.31 1,201,668 479
Norfolk, VA $130.83 $17.86 – $706.06 1,218,408 199
Knoxville, TN $112.38 $0.00 – $767.57 1,231,223 308
Rochester, NY $129.50 $0.00 – $708.14 1,243,277 395
Shreveport, LA $102.85 $25.26 – $546.31 1,321,407 307
Charleston, SC $65.50 $15.74 – $385.33 1,335,995 321
Newark, NJ $253.51 $0.00 – $475.16 1,339,209 262
Pittsburgh, PA $104.00 $0.00 – $341.16 1,342,847 567
Lansing, MI $101.01 $27.00 – $539.40 1,391,720 69
Birmingham, AL $80.96 $0.00 – $521.40 1,417,392 464
New Haven, CT $223.61 $4.69 – $605.48 1,483,537 424
Saint Louis, MO $128.84 $0.00 – $1,498 1,505,298 965
Oklahoma City, OK $141.78 $0.00 – $544.76 1,523,446 412
Fort Worth, TX $219.10 $0.00 – $1,986 1,524,539 489
Riverside, CA $105.30 $0.05 – $287.58 1,531,635 181
Miami, FL $96.60 $0.00 – $653.31 1,553,357 810
Seattle, WA $91.01 $6.86 – $329.92 1,579,665 551
Jackson, MS $109.91 $6.03 – $294.37 1,613,802 313
Hartford, CT $216.04 $0.64 – $1,025 1,622,100 330
Portland, OR $158.80 $0.00 – $2,230 1,692,627 553
Aurora, CO $123.06 $4.40 – $669.12 1,707,782 663
Atlanta, GA $261.11 $0.00 – $538.83 1,736,171 660
Bakersfield, CA $198.12 $0.00 – $463.19 1,742,847 242
Dayton, OH $97.08 $10.95 – $277.79 1,743,160 360
Sacramento, CA $137.25 $0.00 – $1,045 1,743,927 571
Albuquerque, NM $154.16 $0.52 – $431.19 1,757,889 555

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.