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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
Cave Creek, AZ $97.70 $70.60 – $208.66 20,027 4
Englewood, FL $86.95 $55.10 – $107.87 20,038 4
Mobridge, SD $58.65 $42.65 – $102.15 20,074 8
Fairmont, MN $130.73 $97.27 – $202.34 20,075 7
Bar Harbor, ME $32.61 $21.29 – $79.16 20,081 6
League City, TX $150.32 $35.65 – $304.38 20,090 14
Elizabethtown, NY $229.22 $45.56 – $234.07 20,149 5
Kittanning, PA $73.20 $38.21 – $87.54 20,161 10
Poplarville, MS $116.37 $12.65 – $135.97 20,207 6
Lafayette, TN $82.82 $32.08 – $86.51 20,230 3
Park Falls, WI $191.01 $40.51 – $234.98 20,231 8
Harker Heights, TX $130.60 $46.53 – $333.37 20,256 10
Richfield, UT $50.10 $34.20 – $112.45 20,286 9
Robbinsdale, MN $142.27 $47.05 – $1,282 20,305 24
Mount Vernon, IL $51.17 $21.11 – $117.17 20,337 14
Rutherfordton, NC $69.15 $51.56 – $139.72 20,352 12
South Portland, ME $58.88 $27.21 – $100.69 20,353 25
Barnwell, SC $105.97 $105.97 – $105.97 20,354 1
Monongahela, PA $104.33 $50.95 – $125.76 20,361 10
Angier, NC $73.01 $73.01 – $73.01 20,379 1
Decorah, IA $82.86 $52.29 – $125.39 20,385 6
South Sioux City, NE $130.24 $43.33 – $139.81 20,413 4
Dayton, WA $178.64 $23.85 – $332.12 20,416 6
Cutler, IN $103.77 $103.77 – $103.77 20,430 1
Escalon, CA $66.10 $66.10 – $66.10 20,489 1
Calhoun City, MS $144.06 $8.77 – $151.87 20,531 3
Siler City, NC $94.52 $77.48 – $106.79 20,558 8
Shelby Twp, MI $122.77 $122.77 – $122.77 20,566 1
Big Sky, MT $89.52 $0.00 – $161.65 20,684 14
Ridgeland, MS $51.75 $22.09 – $94.63 20,749 6
Kilmarnock, VA $211.51 $57.08 – $230.84 20,776 3
Ontario, OR $75.36 $27.79 – $195.62 20,790 9
Neptune City, NJ $65.01 $49.72 – $82.76 20,797 5
Bean Station, TN $113.12 $113.12 – $113.12 20,803 1
Fremont, NE $90.10 $44.91 – $110.55 20,875 10
Mendenhall, MS $111.96 $1.70 – $135.14 20,883 7
Willows, CA $70.38 $0.26 – $140.37 20,971 6
Takoma Park, MD $109.51 $65.85 – $196.38 21,018 15
Marshall, MN $154.57 $71.89 – $192.28 21,041 8
Englewood Cliffs, NJ $45.43 $43.14 – $89.34 21,058 3
Hurricane, WV $74.69 $47.48 – $261.19 21,102 8
Foley, AL $64.65 $0.00 – $367.52 21,127 19
Lowville, NY $183.70 $79.23 – $224.53 21,131 2
Newnan, GA $82.58 $13.21 – $147.02 21,152 9
Defuniak Springs, FL $56.93 $0.00 – $67.07 21,218 7
Elkmont, AL $47.24 $15.90 – $47.40 21,250 3
Brenham, TX $148.89 $43.47 – $196.00 21,266 11
Pineville, KY $124.82 $56.68 – $129.11 21,317 3
Pigeon, MI $132.31 $59.57 – $207.07 21,325 3
El Dorado Hills, CA $58.32 $42.00 – $104.13 21,329 3

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.