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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
Manchester, KY $115.76 $36.00 – $136.71 99,597 8
Wilmington, OH $81.92 $37.95 – $183.59 99,588 20
Kirkland, WA $77.60 $10.22 – $106.84 99,207 23
Saint Joseph, MO $128.77 $44.16 – $443.76 99,206 69
Chicago Heights, IL $82.02 $24.20 – $151.33 98,941 21
East Boston, MA $86.63 $52.19 – $138.20 98,842 18
Freehold, NJ $303.18 $19.34 – $427.28 98,837 29
Wildomar, CA $77.55 $11.58 – $297.73 98,772 15
Northampton, MA $95.84 $22.05 – $200.18 98,711 34
Norway, ME $14.21 $12.65 – $77.71 98,648 7
South Charleston, WV $104.71 $44.87 – $244.13 98,390 26
Covington, WA $114.43 $29.98 – $192.08 98,291 6
Valley Stream, NY $126.89 $39.63 – $310.00 98,022 35
Jacksonville, NC $100.17 $2.31 – $192.09 98,021 40
Shawano, WI $160.35 $25.89 – $196.37 97,808 13
Laurinburg, NC $82.09 $31.16 – $192.51 97,758 17
Bessemer, AL $75.44 $24.11 – $111.48 97,741 16
Reedley, CA $27.46 $11.73 – $368.71 97,688 11
Germantown, MD $108.47 $29.02 – $513.08 97,681 56
Kalispell, MT $64.81 $0.97 – $294.36 97,679 33
West Burlington, IA $118.62 $16.45 – $204.96 97,381 18
Dover, OH $78.68 $32.39 – $115.96 97,135 21
Sanford, NC $111.03 $43.22 – $234.22 97,101 25
Santa Ana, CA $70.60 $0.00 – $191.90 97,095 50
Fullerton, CA $68.74 $29.02 – $170.88 96,981 28
Smyrna, TN $131.91 $3.64 – $420.53 96,936 26
Leominster, MA $143.57 $34.38 – $194.14 96,862 22
Forest Hills, NY $86.21 $20.86 – $178.78 96,498 41
Reston, VA $138.67 $32.56 – $172.02 96,483 31
Brentwood, TN $80.17 $21.36 – $265.33 96,460 28
Taylor, MI $236.71 $43.19 – $273.59 96,421 5
Greenwich, CT $208.63 $24.82 – $292.63 96,373 19
North Kansas City, MO $87.69 $14.52 – $469.30 95,873 46
Petaluma, CA $66.28 $0.00 – $899.44 95,833 49
Sylmar, CA $18.72 $4.83 – $179.24 95,825 22
Simi Valley, CA $95.07 $51.38 – $221.44 95,749 19
Putnam, CT $198.64 $1.62 – $258.08 95,657 11
Morgan City, LA $95.29 $36.31 – $141.17 95,463 17
Prestonsburg, KY $185.68 $8.76 – $220.08 95,247 10
Queen Creek, AZ $239.61 $55.42 – $300.35 94,889 8
Elma, WA $222.03 $28.25 – $477.29 94,715 10
Ruston, LA $82.22 $47.26 – $226.35 94,580 20
Crowley, LA $83.43 $55.30 – $119.19 94,489 13
Dickson, TN $114.25 $38.77 – $469.12 94,443 24
Alliance, OH $87.57 $0.96 – $153.73 94,432 19
Maysville, KY $104.32 $23.59 – $162.76 94,212 5
Springfield, TN $99.70 $36.03 – $390.61 93,989 19
Dorchester Center, MA $183.58 $18.73 – $332.60 93,911 6
Guntersville, AL $46.40 $31.74 – $99.90 93,722 15
Starkville, MS $120.97 $31.33 – $255.90 93,686 17

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.