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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
Savannah, GA $64.19 $14.22 – $814.86 176,153 74
Sandusky, OH $84.02 $52.87 – $194.50 175,771 31
East Meadow, NY $110.54 $2.59 – $1,135 175,706 60
Marion, IN $93.56 $42.23 – $233.33 175,596 24
Elmhurst, IL $69.11 $28.44 – $130.26 175,398 39
Henderson, KY $159.57 $22.72 – $274.71 175,345 17
Munster, IN $101.32 $31.50 – $201.36 175,187 59
Greenville, MS $92.45 $2.55 – $122.65 174,672 27
Greenwood, SC $48.26 $28.18 – $430.17 174,432 43
Grand Junction, CO $94.29 $10.55 – $167.39 174,201 57
West Covina, CA $46.31 $0.00 – $121.02 173,869 26
Lorain, OH $85.32 $4.65 – $115.70 173,745 33
Cuyahoga Falls, OH $86.00 $36.52 – $129.48 173,738 24
West Hills, CA $55.27 $0.00 – $117.00 173,638 46
Jonesboro, AR $64.86 $3.85 – $364.45 173,452 77
Brick, NJ $201.57 $4.95 – $311.26 173,369 28
Williamsville, NY $99.33 $25.64 – $177.87 173,209 54
Rapid City, SD $76.07 $9.54 – $402.81 172,907 45
Council Bluffs, IA $115.88 $15.88 – $863.03 172,860 38
Chino, CA $61.70 $7.07 – $84.68 172,727 21
Eau Claire, WI $55.46 $0.00 – $486.35 172,380 95
Avon, IN $116.74 $0.00 – $233.24 171,821 46
Anderson, SC $48.88 $0.00 – $261.62 171,679 49
Emeryville, CA $63.24 $0.00 – $182.08 171,513 47
Biddeford, ME $127.05 $26.62 – $177.08 170,953 51
Adrian, MI $95.01 $56.21 – $156.72 170,753 7
Amarillo, TX $138.27 $8.25 – $876.03 170,747 84
Spokane Valley, WA $84.22 $0.00 – $369.36 170,517 24
Walla Walla, WA $80.00 $35.22 – $144.27 169,738 22
Duluth, MN $151.89 $33.30 – $1,651 169,721 101
Napa, CA $90.93 $0.00 – $933.97 169,696 40
Mount Vernon, WA $97.48 $0.00 – $133.84 169,367 26
Thibodaux, LA $76.98 $31.46 – $401.92 168,827 31
Augusta, ME $128.80 $10.07 – $342.00 168,482 36
Harlingen, TX $124.90 $17.88 – $291.28 168,271 62
Atlantic City, NJ $48.62 $8.46 – $175.49 167,878 40
Salem, MA $116.60 $35.67 – $183.00 167,439 46
Parkersburg, WV $125.55 $36.46 – $410.71 167,294 31
Sun City, AZ $144.53 $51.50 – $287.31 167,274 39
Grosse Pointe, MI $214.10 $44.62 – $250.93 166,329 11
Gallipolis, OH $100.16 $44.33 – $235.14 166,202 26
Madisonville, KY $147.72 $34.24 – $242.44 166,082 21
Morehead, KY $108.91 $26.17 – $384.56 166,037 39
Tempe, AZ $128.85 $22.85 – $192.07 165,944 30
Kingwood, TX $135.02 $36.11 – $1,298 165,929 44
West Reading, PA $98.99 $0.00 – $267.73 165,328 65
Far Rockaway, NY $138.38 $13.37 – $224.61 164,900 37
Valhalla, NY $138.00 $24.41 – $331.11 164,878 55
Binghamton, NY $133.96 $42.84 – $154.04 164,441 13
Albany, GA $107.12 $42.05 – $118.68 164,421 29

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.