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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
Redlands, CA $71.75 $2.10 – $127.46 127,798 31
Wichita Falls, TX $116.22 $0.00 – $306.08 127,475 41
Winter Haven, FL $70.39 $0.00 – $160.44 127,135 34
Lebanon, OR $163.77 $26.87 – $207.66 126,970 24
Holland, MI $115.14 $48.28 – $182.68 126,522 4
Bowling Green, OH $82.58 $40.70 – $152.16 126,350 26
Bolivia, NC $118.52 $54.29 – $159.65 126,335 21
Marion, OH $90.84 $22.92 – $124.30 126,221 24
St George, UT $70.79 $0.00 – $206.10 126,098 38
Palmer, MA $108.27 $16.76 – $173.47 125,922 22
Newburgh, NY $127.06 $28.13 – $168.32 125,900 23
Wauwatosa, WI $43.46 $13.51 – $83.84 125,870 54
Lexington, TN $78.42 $36.66 – $225.48 125,842 13
Greenwood, MS $102.06 $14.22 – $129.65 125,793 26
Hialeah, FL $61.88 $0.00 – $332.10 125,429 63
Columbus, GA $66.05 $0.00 – $140.14 125,376 58
Englewood, NJ $126.34 $32.69 – $191.29 124,878 37
Aiea, HI $336.11 $0.00 – $503.44 124,728 17
Aberdeen, WA $157.02 $61.96 – $182.62 124,589 8
Beloit, WI $57.49 $11.87 – $62.06 124,331 21
Martinsville, VA $111.38 $48.72 – $155.82 124,271 16
Oshkosh, WI $55.31 $20.19 – $168.62 124,172 32
Burlington, VT $56.39 $0.00 – $406.71 123,025 108
Idaho Falls, ID $117.85 $39.71 – $177.78 122,984 24
Covina, CA $58.12 $34.15 – $100.96 122,922 15
Woodland, CA $94.10 $0.00 – $913.00 122,917 18
Terrytown, LA $106.27 $31.70 – $434.96 122,881 32
Mayfield, KY $137.80 $38.70 – $185.46 122,464 13
Cookeville, TN $81.19 $31.79 – $249.55 122,449 46
Sarasota, FL $68.25 $5.58 – $231.20 122,368 120
Clearwater, FL $68.14 $0.00 – $159.09 122,364 82
Temecula, CA $68.16 $0.06 – $122.25 122,125 28
Hyannis, MA $127.55 $33.95 – $233.57 122,041 46
Oberlin, OH $90.07 $45.12 – $141.24 122,039 13
New Albany, MS $125.62 $22.70 – $153.53 121,901 14
Bay City, MI $153.28 $48.26 – $168.22 121,432 9
Round Rock, TX $102.87 $0.00 – $634.50 121,395 83
Beaufort, SC $41.76 $19.55 – $173.18 121,314 21
Danville, IN $116.24 $27.36 – $177.45 121,253 33
Pine Bluff, AR $63.97 $32.57 – $204.56 121,243 39
French Camp, CA $80.06 $4.34 – $136.99 121,219 27
Batavia, OH $93.23 $33.39 – $137.55 121,043 25
Macon, GA $79.62 $0.00 – $252.51 120,832 95
Monroe, NC $86.44 $22.53 – $167.46 120,795 42
Camden, SC $71.66 $29.95 – $149.79 120,792 14
Gardena, CA $64.49 $38.53 – $290.44 120,685 20
Texarkana, TX $112.65 $32.71 – $596.94 120,387 43
Hamilton, OH $93.92 $46.43 – $123.95 120,353 19
Wailuku, HI $390.79 $6.96 – $509.70 120,290 29
West Allis, WI $59.52 $23.43 – $135.12 120,267 16

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.