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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
Brookhaven, MS $107.22 $7.52 – $138.74 152,011 24
Richmond, KY $158.07 $44.05 – $205.00 151,769 7
Centralia, WA $88.25 $49.68 – $141.65 151,632 19
Hanford, CA $25.74 $5.83 – $185.74 150,763 22
Warwick, RI $101.75 $0.00 – $301.78 150,623 79
Lancaster, PA $85.60 $0.00 – $638.95 150,561 61
Joliet, IL $77.12 $24.17 – $151.62 150,445 49
Myrlte Beach, SC $57.67 $57.67 – $57.67 150,141 1
Fairbanks, AK $324.63 $57.65 – $452.99 149,535 25
Aurora, IL $61.67 $32.20 – $160.43 148,898 37
Port St Lucie, FL $73.21 $6.68 – $333.74 148,710 51
Deland, FL $88.91 $15.72 – $142.32 148,681 29
Decatur, GA $119.94 $19.69 – $137.30 148,510 39
Conway, SC $38.64 $27.32 – $203.83 148,290 17
Long Branch, NJ $280.47 $26.00 – $380.39 147,676 23
Biloxi, MS $104.80 $21.92 – $169.50 146,810 25
Gary, IN $104.80 $48.42 – $179.23 145,760 27
Schenectady, NY $101.76 $4.53 – $147.79 145,697 53
Albany, OR $152.05 $26.20 – $449.74 144,955 33
Camp Lejeune, NC $105.52 $0.00 – $201.16 144,924 33
Montclair, NJ $236.11 $31.35 – $392.91 144,725 27
Sheboygan, WI $52.42 $12.67 – $226.02 144,586 29
Park Ridge, IL $58.49 $24.60 – $201.66 144,532 79
Brownsville, TX $119.39 $0.22 – $390.11 144,528 54
Morristown, TN $113.43 $13.79 – $254.81 144,306 27
Trenton, MI $159.99 $35.34 – $263.13 143,925 22
Eugene, OR $141.50 $5.61 – $574.47 143,888 37
New Rochelle, NY $93.75 $20.91 – $153.38 143,662 18
Arlington, TX $105.22 $0.00 – $760.25 143,585 78
Derby, CT $257.91 $11.85 – $332.92 143,485 23
Pasadena, TX $168.39 $0.43 – $1,310 142,654 56
La Jolla, CA $75.86 $18.01 – $344.22 141,788 69
Roseburg, OR $122.45 $56.44 – $770.57 141,697 38
Glendora, CA $61.31 $22.50 – $81.61 141,130 16
Aiken, SC $47.39 $33.34 – $161.25 141,007 13
Vincennes, IN $89.87 $26.08 – $105.16 140,802 20
Frankfort, KY $173.35 $22.11 – $231.72 140,227 14
Show Low, AZ $187.35 $10.77 – $239.15 140,101 28
Kennewick, WA $87.44 $32.30 – $148.49 140,080 20
Edmonds, WA $87.36 $58.95 – $106.86 139,908 21
Hillsboro, OR $163.85 $6.12 – $352.94 139,746 37
Williamsport, PA $77.43 $1.80 – $156.50 139,701 33
Lancaster, OH $86.82 $31.58 – $119.94 139,499 32
Hudson, OH $85.30 $30.81 – $199.60 139,366 22
Oak Park, IL $68.69 $22.89 – $139.54 139,279 44
Georgetown, KY $136.80 $45.51 – $184.17 138,532 15
Jeffersonville, IN $95.07 $19.97 – $253.39 138,300 27
Norton, VA $91.40 $24.44 – $199.35 138,128 21
Sun City West, AZ $181.45 $51.60 – $240.91 137,962 37
Tarzana, CA $55.35 $20.55 – $207.18 137,311 28

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.