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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
Terre Haute, IN $94.04 $18.48 – $271.01 194,040 55
Edinburg, TX $249.60 $0.00 – $477.40 194,012 73
Palmdale, CA $94.04 $0.00 – $155.48 193,943 23
Redmond, OR $92.20 $38.96 – $267.66 193,752 65
Fremont, CA $96.52 $0.00 – $326.86 192,926 45
Somers Point, NJ $192.65 $23.50 – $321.75 192,447 16
Suffolk, VA $148.34 $46.03 – $156.48 191,952 18
Aventura, FL $68.78 $0.00 – $251.51 191,707 65
Flagstaff, AZ $212.77 $33.93 – $291.31 190,695 57
Utica, NY $214.25 $49.23 – $368.26 190,597 37
Corona, CA $69.87 $6.90 – $167.77 189,546 34
Santa Maria, CA $58.29 $0.00 – $199.09 188,411 45
Monterey, CA $81.64 $1.46 – $157.17 188,389 36
Boynton Beach, FL $85.46 $0.00 – $289.20 187,990 49
New Albany, IN $103.77 $13.29 – $274.58 187,488 31
Great Falls, MT $48.59 $10.02 – $205.00 187,468 52
Richmond Hill, NY $187.49 $28.70 – $270.48 186,899 26
Van Nuys, CA $52.80 $15.99 – $128.38 186,817 28
Casa Grande, AZ $214.62 $65.93 – $272.49 186,565 25
Clinton Township, MI $75.94 $30.43 – $147.69 186,506 38
Bay Shore, NY $141.76 $38.54 – $208.50 186,421 44
Mount Holly, NJ $249.21 $24.54 – $365.45 186,337 25
Northridge, CA $71.38 $3.73 – $172.01 186,002 38
Miami Beach, FL $71.70 $13.02 – $217.13 185,812 76
Rock Hill, SC $43.04 $25.16 – $166.23 185,783 28
Burlington, NC $123.48 $0.00 – $256.19 185,726 49
Yonkers, NY $165.27 $12.33 – $230.37 184,296 48
Hickory, NC $109.35 $49.75 – $219.75 183,410 61
New Bern, NC $104.92 $0.00 – $363.83 183,032 35
Ogden, UT $48.92 $24.52 – $156.51 182,939 46
Dothan, AL $53.08 $0.00 – $136.56 182,523 55
Escondido, CA $199.96 $36.63 – $1,032 182,324 35
Mccomb, MS $107.22 $7.34 – $146.51 181,110 25
South Bend, IN $95.59 $15.16 – $201.70 180,378 53
Elyria, OH $92.22 $4.91 – $148.67 179,884 35
Bossier City, LA $79.99 $31.93 – $375.69 179,637 32
Monroe, MI $122.39 $47.30 – $193.72 179,511 33
Johnstown, PA $91.08 $30.78 – $974.30 179,193 61
West Palm Beach, FL $76.33 $3.96 – $168.16 179,091 73
Bethel, AK $122.45 $90.85 – $143.65 178,268 3
Ft Lauderdale, FL $83.00 $0.00 – $208.21 178,196 59
Long Island City, NY $133.32 $37.67 – $149.72 177,877 26
Methuen, MA $83.30 $36.82 – $250.90 177,704 23
San Leandro, CA $189.34 $0.00 – $323.85 177,150 65
Pittsfield, MA $163.41 $0.00 – $241.25 177,109 47
Springdale, AR $63.43 $1.15 – $163.44 177,040 43
Norwalk, CT $211.47 $17.44 – $323.75 176,997 46
Antioch, CA $88.53 $0.00 – $346.25 176,888 31
Harrisonburg, VA $127.95 $41.30 – $152.21 176,693 22
Beaumont, TX $134.47 $2.59 – $554.87 176,309 56

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.