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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
Culpeper, VA $202.07 $38.91 – $232.78 106,692 18
Franklin, TN $96.27 $33.27 – $182.44 106,621 31
South Boston, VA $110.99 $18.51 – $133.68 106,244 15
South Hill, VA $163.84 $23.55 – $227.51 106,165 16
Cottonwood, AZ $160.40 $37.26 – $224.41 105,952 20
Shelton, WA $244.13 $54.49 – $339.07 105,856 9
Mankato, MN $211.84 $22.93 – $1,085 105,745 61
Carrollton, GA $69.98 $4.29 – $115.32 105,719 35
Dubuque, IA $121.29 $24.47 – $234.47 105,556 27
Southbridge, MA $140.99 $27.22 – $169.48 105,545 23
Orange Park, FL $75.68 $18.62 – $169.47 105,510 46
Farmville, VA $131.92 $36.67 – $145.71 104,828 10
Tracy, CA $64.60 $17.43 – $132.29 104,741 15
Burlington, MA $129.97 $5.13 – $212.26 104,721 86
Lakeport, CA $221.54 $0.00 – $730.48 104,687 17
Kokomo, IN $99.17 $8.31 – $178.94 104,685 29
Marysville, CA $67.96 $0.00 – $876.53 104,663 34
The Woodlands, TX $137.28 $32.99 – $468.07 104,621 48
Clare, MI $110.33 $57.50 – $153.19 104,503 3
Marietta, GA $107.49 $10.66 – $528.44 104,415 60
Annapolis, MD $85.03 $0.00 – $206.55 104,255 55
Harvey, IL $58.66 $34.64 – $102.83 104,199 22
Franklin, OH $96.59 $34.16 – $137.80 103,990 13
Kenner, LA $114.92 $51.18 – $212.89 103,869 32
Hammond, IN $77.94 $26.70 – $105.08 103,729 22
Lakewood, NJ $275.72 $31.92 – $373.84 103,454 22
Nogales, AZ $251.21 $24.80 – $394.28 103,283 15
Ardmore, OK $153.02 $56.18 – $180.04 102,812 20
Coeur D Alene, ID $75.69 $34.41 – $173.47 102,696 51
Lodi, CA $66.50 $9.81 – $128.22 102,429 23
Leitchfield, KY $142.45 $26.81 – $199.32 102,155 9
Rahway, NJ $178.74 $26.00 – $221.54 101,969 20
Phillipsburg, NJ $265.62 $32.13 – $358.79 101,867 7
Coral Springs, FL $82.53 $0.00 – $285.96 101,863 52
Gallatin, TN $100.84 $1.26 – $188.36 101,829 32
Belleville, IL $70.22 $29.90 – $257.63 101,619 35
Bullhead City, AZ $155.41 $1.37 – $178.53 101,344 12
Summerville, SC $63.51 $22.35 – $247.08 101,171 22
Safford, AZ $146.68 $40.78 – $186.05 100,907 12
Avon, OH $85.34 $42.50 – $104.41 100,898 15
Parma, OH $89.77 $0.00 – $259.14 100,792 29
Riverdale, GA $145.52 $32.22 – $163.48 100,767 12
Rocky Mount, NC $114.71 $0.20 – $252.29 100,682 29
Bozeman, MT $65.81 $2.52 – $266.72 100,630 42
Norwalk, OH $84.51 $7.18 – $113.41 100,320 14
Arlington Heights, IL $69.28 $30.02 – $208.19 100,309 38
Rock Island, IL $79.18 $14.19 – $197.03 100,171 32
Gadsden, AL $55.60 $16.50 – $137.74 100,040 28
North Wilkesboro, NC $129.46 $43.29 – $232.15 99,974 28
Hamilton, NJ $156.15 $25.67 – $221.74 99,636 24

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.