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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
Manahawkin, NJ $215.76 $24.62 – $321.16 119,987 17
Menomonee Falls, WI $53.39 $14.53 – $88.19 119,875 22
Plantation, FL $73.01 $0.00 – $248.79 119,828 63
Martinsburg, WV $125.16 $43.65 – $417.16 119,616 24
Hillsboro, OH $92.09 $7.73 – $351.50 119,507 17
East Orange, NJ $191.23 $23.03 – $222.82 119,485 17
Walterboro, SC $55.68 $12.51 – $95.83 119,366 10
Hagerstown, MD $112.51 $32.46 – $222.85 119,319 46
Bartlett, TN $95.53 $2.00 – $184.13 119,107 23
Delaware, OH $80.45 $55.47 – $130.41 119,099 18
Monterey Park, CA $89.98 $0.00 – $328.77 118,990 38
Manistee, MI $85.55 $58.05 – $150.40 118,938 4
Wausau, WI $47.55 $15.75 – $160.80 118,931 24
Lebanon, PA $116.77 $0.00 – $270.00 118,548 34
Sherman Oaks, CA $60.65 $11.50 – $184.08 118,496 38
Brawley, CA $84.34 $39.44 – $434.53 118,158 12
Altoona, PA $96.35 $48.99 – $158.98 117,922 30
Battle Creek, MI $151.73 $24.32 – $153.61 117,735 5
Alpena, MI $97.56 $58.19 – $183.73 117,680 6
Alamogordo, NM $183.08 $37.37 – $325.25 117,331 19
Oceanside, NY $124.88 $28.64 – $182.88 117,109 42
Teaneck, NJ $217.13 $29.60 – $263.76 117,095 18
Ravenna, OH $88.75 $34.38 – $136.61 116,969 22
Delano, CA $198.08 $0.00 – $383.25 116,815 11
Bismarck, ND $179.72 $33.78 – $333.31 116,805 56
Pasco, WA $170.07 $21.26 – $215.10 116,077 17
Hot Springs, AR $60.40 $9.70 – $148.66 116,030 52
Silver Spring, MD $125.73 $34.01 – $563.91 115,966 77
Valparaiso, IN $96.61 $14.58 – $145.01 115,868 21
Willingboro, NJ $252.75 $39.29 – $318.56 115,695 8
Paris, TN $80.78 $25.59 – $136.96 115,550 20
Evergreen Park, IL $68.61 $34.05 – $148.18 115,323 19
Quincy, IL $66.19 $2.09 – $157.70 115,154 34
Columbia, TN $106.56 $0.00 – $234.23 115,078 33
Abingdon, VA $108.00 $0.00 – $294.20 114,975 34
Hendersonville, TN $148.37 $0.00 – $433.04 114,731 26
Maplewood, MN $178.20 $55.51 – $259.35 114,648 52
Picayune, MS $123.83 $34.52 – $181.04 114,426 10
Patchogue, NY $120.73 $28.04 – $158.74 114,359 25
Bradenton, FL $67.04 $9.62 – $626.41 113,958 68
Natchez, MS $99.52 $19.94 – $327.81 113,934 14
Humble, TX $167.01 $1.68 – $223.80 113,635 38
Santa Barbara, CA $37.95 $6.40 – $586.15 113,423 62
South Weymouth, MA $176.93 $45.11 – $196.93 113,403 16
White Plains, NY $129.72 $20.49 – $173.21 113,308 36
Overland Park, KS $86.21 $11.01 – $826.47 113,299 86
Mishawaka, IN $111.42 $9.89 – $640.10 113,054 27
Odessa, TX $121.71 $6.63 – $1,635 112,959 51
Fairfax, VA $146.50 $28.78 – $197.02 112,945 37
Davis, CA $93.18 $0.00 – $113.87 112,885 27

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.