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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
Moses Lake, WA $84.16 $26.60 – $232.63 164,008 25
Glasgow, KY $130.60 $22.26 – $298.00 163,568 28
Bellevue, WA $74.33 $8.39 – $153.83 163,371 65
Palmer, AK $215.99 $113.00 – $259.25 163,311 16
Ponce, PR $84.18 $0.00 – $340.17 162,937 106
Burien, WA $84.04 $30.54 – $90.64 162,936 22
Euclid, OH $100.75 $40.72 – $137.80 162,785 20
Evanston, IL $67.03 $29.71 – $281.05 162,622 94
Los Banos, CA $72.18 $0.00 – $352.59 161,825 15
Sevierville, TN $116.03 $30.23 – $539.07 161,635 26
Fort Bragg, NC $93.62 $0.00 – $305.90 161,503 69
Greenbrae, CA $96.74 $0.07 – $1,086 161,373 22
Bristol, CT $188.69 $0.00 – $229.89 161,192 16
Berkeley, CA $72.88 $0.34 – $240.22 161,073 51
Clackamas, OR $171.70 $59.99 – $422.90 160,884 78
Pleasant Prairie, WI $60.11 $24.66 – $123.47 160,653 12
Lakewood, WA $82.63 $24.30 – $296.39 160,560 20
Banning, CA $70.56 $48.33 – $164.64 160,378 17
Vicksburg, MS $110.62 $29.43 – $152.24 160,312 18
Lancaster, SC $65.48 $6.04 – $160.60 159,664 22
Lapeer, MI $112.42 $73.08 – $194.28 158,752 2
Watsonville, CA $86.08 $21.78 – $166.99 158,516 13
Southaven, MS $126.79 $20.76 – $157.80 158,505 34
Sumter, SC $38.43 $29.96 – $136.42 157,791 14
Franklin, VA $90.92 $47.81 – $502.29 157,596 11
Midlothian, VA $147.07 $40.06 – $233.69 157,268 26
Princeton, WV $122.81 $15.99 – $606.41 156,749 18
Panorama City, CA $259.51 $0.00 – $476.01 156,721 34
Indio, CA $162.66 $31.05 – $263.97 155,794 10
Ypsilanti, MI $211.38 $27.81 – $500.84 155,402 19
Bristol, TN $115.41 $17.01 – $151.14 155,283 30
Manchester, CT $131.43 $0.00 – $260.11 155,133 36
Warrensville Heights, OH $106.49 $34.74 – $150.82 155,098 22
Grants Pass, OR $129.21 $54.64 – $1,102 154,540 43
Torrington, CT $252.82 $10.13 – $362.16 154,420 24
Wheat Ridge, CO $96.51 $49.77 – $203.51 154,418 46
Kenosha, WI $52.98 $18.32 – $84.90 154,321 37
Burbank, CA $60.04 $0.00 – $249.89 154,272 39
Castro Valley, CA $118.75 $12.97 – $199.45 154,266 28
Fort Lauderdale, FL $77.87 $3.37 – $242.05 153,587 78
Mineola, NY $130.35 $23.59 – $409.33 153,504 57
Nashua, NH $88.02 $29.57 – $160.27 153,287 37
San Pedro, CA $61.11 $0.00 – $117.34 152,642 21
Carbondale, IL $61.27 $26.27 – $212.66 152,544 52
Alma, MI $113.15 $63.17 – $162.90 152,504 4
Selma, CA $13.45 $1.96 – $65.45 152,417 16
Naples, FL $88.35 $24.92 – $1,015 152,413 93
Decatur, IL $61.57 $24.24 – $379.80 152,348 38
Germantown, TN $102.60 $0.00 – $367.06 152,110 53
Oxnard, CA $113.16 $0.43 – $278.90 152,027 40

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.