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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
Moore, OK $137.03 $37.11 – $191.77 137,177 32
Winchester, KY $189.93 $36.35 – $212.26 137,085 12
Jamestown, NY $133.90 $0.00 – $436.87 136,969 21
Skowhegan, ME $18.50 $15.49 – $69.10 136,775 16
Hilo, HI $270.52 $66.00 – $296.16 136,740 11
Troy, MI $283.13 $31.29 – $300.10 136,526 11
Olive Branch, MS $110.49 $24.15 – $150.99 136,502 16
Wayne, MI $212.00 $38.79 – $222.25 136,004 6
Chico, CA $62.28 $0.05 – $776.21 135,596 33
Newport Beach, CA $59.27 $0.36 – $156.84 135,511 48
Loris, SC $51.92 $36.77 – $116.69 135,458 6
Hopkinsville, KY $112.13 $32.74 – $132.53 135,129 7
Panama City, FL $80.84 $0.00 – $190.74 134,870 68
Salisbury, NC $108.64 $36.55 – $184.74 134,536 29
Holyoke, MA $152.02 $7.11 – $181.95 134,354 19
Cleveland, TN $88.19 $18.02 – $342.57 134,309 29
Elgin, IL $65.86 $15.43 – $138.47 134,276 50
Petoskey, MI $104.07 $56.39 – $148.68 134,210 7
Florence, KY $220.04 $41.58 – $246.45 133,893 13
Provo, UT $63.83 $32.58 – $144.00 133,845 48
Manassas, VA $204.83 $16.63 – $256.48 133,713 31
Bend, OR $86.52 $0.00 – $1,611 133,384 75
Concord, NH $99.44 $0.00 – $240.26 133,241 59
Folsom, CA $101.51 $6.64 – $185.32 132,874 36
Cape Girardeau, MO $99.47 $4.16 – $999.47 132,806 65
Hobart, IN $106.05 $53.36 – $207.01 132,661 14
Boulder, CO $96.18 $0.00 – $175.21 132,331 44
Maywood, IL $78.84 $14.60 – $186.21 131,766 87
Mission, TX $146.80 $30.42 – $289.30 131,388 23
Greer, SC $40.62 $16.23 – $96.18 131,314 12
Arlington, VA $134.76 $46.68 – $168.61 131,100 46
Cape May Court House, NJ $192.94 $31.72 – $261.12 131,067 14
Florence, AL $57.51 $0.00 – $107.66 130,915 35
Jackson, KY $159.82 $13.14 – $212.06 130,882 6
Opelousas, LA $82.19 $46.72 – $262.74 130,866 31
Hazel Crest, IL $72.86 $30.40 – $167.56 130,863 39
Plano, TX $138.94 $23.18 – $297.43 130,721 69
Big Stone Gap, VA $124.83 $0.00 – $146.47 130,643 13
Bayamon, PR $52.66 $0.00 – $337.39 130,431 78
Elmira, NY $96.28 $22.51 – $181.90 129,701 35
Coldwater, MI $93.47 $21.82 – $147.29 129,493 7
Oxford, MS $120.59 $10.73 – $299.71 129,348 26
Espanola, NM $151.28 $63.63 – $177.49 129,106 16
Baldwin Park, CA $276.35 $2.23 – $399.29 128,994 30
Owosso, MI $116.73 $44.32 – $170.55 128,615 5
Manhattan Beach, CA $61.44 $11.50 – $109.54 128,569 28
Hayward, CA $54.30 $25.92 – $114.06 128,479 23
Clearlake, CA $105.82 $0.00 – $710.71 128,311 21
College Station, TX $119.80 $0.20 – $297.56 128,210 63
Bellflower, CA $67.99 $0.00 – $205.98 127,893 36

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.