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 — 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 |
|---|---|---|---|---|
| San Antonio, TX | $126.61 | $0.00 – $1,112 | 1,783,972 | 691 |
| Akron, OH | $101.47 | $0.00 – $412.20 | 1,830,030 | 396 |
| Memphis, TN | $119.96 | $0.00 – $954.94 | 1,856,841 | 465 |
| Toledo, OH | $93.09 | $14.43 – $247.63 | 1,886,372 | 319 |
| Nashville, TN | $115.01 | $0.00 – $1,001 | 1,887,270 | 731 |
| Grand Rapids, MI | $106.82 | $19.64 – $587.93 | 1,903,454 | 76 |
| Baltimore, MD | $96.82 | $-13.31 – $395.00 | 1,908,492 | 1013 |
| Orlando, FL | $85.72 | $0.00 – $686.18 | 1,940,642 | 694 |
| Dallas, TX | $145.88 | $0.00 – $1,531 | 1,942,869 | 853 |
| San Diego, CA | $104.48 | $0.00 – $528.82 | 1,987,395 | 726 |
| Las Vegas, NV | $89.64 | $0.00 – $368.64 | 2,035,127 | 798 |
| Richmond, VA | $137.78 | $12.69 – $240.07 | 2,065,177 | 375 |
| Lexington, KY | $156.12 | $2.21 – $436.55 | 2,128,548 | 494 |
| New Orleans, LA | $128.91 | $6.77 – $878.14 | 2,136,041 | 532 |
| Tucson, AZ | $160.21 | $0.00 – $377.45 | 2,175,628 | 489 |
| Charlotte, NC | $128.07 | $0.07 – $1,106 | 2,244,542 | 692 |
| Boston, MA | $120.95 | $0.00 – $923.97 | 2,297,423 | 1146 |
| Cincinnati, OH | $94.36 | $5.74 – $719.78 | 2,312,527 | 649 |
| Washington, DC | $153.94 | $0.00 – $493.21 | 2,354,612 | 687 |
| Houston, TX | $183.70 | $0.00 – $3,136 | 2,360,699 | 1404 |
| Baton Rouge, LA | $116.89 | $0.00 – $771.41 | 2,376,685 | 514 |
| Louisville, KY | $161.52 | $0.00 – $530.61 | 2,991,678 | 505 |
| Los Angeles, CA | $84.68 | $0.00 – $568.48 | 3,238,140 | 1029 |
| Bronx, NY | $138.65 | $0.00 – $971.50 | 3,278,500 | 846 |
| Milwaukee, WI | $64.11 | $9.68 – $338.96 | 3,433,334 | 694 |
| Cleveland, OH | $98.94 | $6.16 – $348.89 | 3,436,346 | 878 |
| Philadelphia, PA | $135.52 | $0.00 – $935.78 | 3,661,931 | 1481 |
| Brooklyn, NY | $130.10 | $0.00 – $421.32 | 3,752,387 | 1080 |
| Columbus, OH | $98.63 | $0.00 – $1,887 | 3,813,295 | 929 |
| New York, NY | $130.02 | $0.00 – $607.31 | 3,905,512 | 1591 |
| Indianapolis, IN | $116.65 | $0.00 – $299.48 | 4,172,341 | 898 |
| Phoenix, AZ | $203.26 | $0.00 – $1,044 | 4,304,161 | 851 |
| Chicago, IL | $84.83 | $0.00 – $3,312 | 4,391,753 | 1550 |
| Detroit, MI | $110.55 | $6.82 – $522.41 | 4,694,783 | 272 |
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.