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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
Birmingham, AL $80.96 $0.00 – $521.40 1,417,392 464
Lansing, MI $101.01 $27.00 – $539.40 1,391,720 69
Pittsburgh, PA $104.00 $0.00 – $341.16 1,342,847 567
Newark, NJ $253.51 $0.00 – $475.16 1,339,209 262
Charleston, SC $65.50 $15.74 – $385.33 1,335,995 321
Shreveport, LA $102.85 $25.26 – $546.31 1,321,407 307
Rochester, NY $129.50 $0.00 – $708.14 1,243,277 395
Knoxville, TN $112.38 $0.00 – $767.57 1,231,223 308
Norfolk, VA $130.83 $17.86 – $706.06 1,218,408 199
Tampa, FL $73.51 $0.00 – $355.31 1,201,668 479
Jacksonville, FL $81.49 $2.29 – $1,442 1,193,809 546
Columbia, SC $72.77 $11.70 – $442.94 1,188,627 275
Fort Wayne, IN $106.03 $11.84 – $1,265 1,181,321 230
Kansas City, MO $140.53 $0.00 – $969.10 1,170,483 482
Tacoma, WA $97.44 $10.77 – $312.18 1,146,159 250
Oakland, CA $83.54 $0.00 – $739.45 1,142,476 332
Kalamazoo, MI $95.58 $14.25 – $312.83 1,136,532 92
Tulsa, OK $146.56 $18.73 – $1,174 1,133,029 457
Denver, CO $97.09 $0.00 – $679.38 1,116,435 447
Lafayette, LA $84.94 $14.79 – $297.74 1,082,809 202
Buffalo, NY $120.86 $0.00 – $406.99 1,082,052 327
Greenville, SC $67.16 $0.00 – $622.02 1,080,286 421
Bethlehem, PA $100.74 $10.73 – $568.31 1,060,730 269
Winston Salem, NC $152.58 $0.00 – $1,070 1,052,025 315
Minneapolis, MN $208.05 $19.21 – $1,683 1,046,400 441
Fresno, CA $38.60 $0.00 – $689.65 1,035,563 315
Mesa, AZ $212.76 $8.66 – $348.21 1,012,467 174
Camden, NJ $221.85 $19.21 – $572.38 991,480 223
El Paso, TX $138.81 $0.00 – $579.72 968,153 286
Kettering, OH $92.55 $17.52 – $227.08 963,000 210
Springfield, MA $119.65 $8.58 – $406.33 960,403 252
Spokane, WA $83.78 $0.00 – $363.51 932,048 183
Raleigh, NC $139.82 $0.00 – $508.66 911,865 230
Salt Lake City, UT $74.59 $16.07 – $612.92 909,018 289
Orange, CA $91.53 $0.02 – $342.95 892,554 267
San Francisco, CA $99.86 $0.00 – $538.38 864,304 454
Falls Church, VA $120.18 $20.35 – $285.23 862,078 132
Honolulu, HI $340.33 $0.42 – $630.04 850,913 229
Paterson, NJ $222.35 $5.78 – $327.33 847,120 104
Saginaw, MI $129.09 $0.00 – $428.82 846,833 64
Royal Oak, MI $126.55 $18.98 – $301.50 821,371 45
Syracuse, NY $125.62 $6.84 – $1,381 815,459 239
Bridgeport, CT $256.71 $8.89 – $393.87 810,081 133
Torrance, CA $60.39 $5.44 – $276.97 801,523 239
Dearborn, MI $118.18 $28.74 – $266.41 797,255 27
Omaha, NE $105.42 $0.00 – $1,094 797,205 294
Loma Linda, CA $195.45 $14.64 – $804.84 795,786 249
Greenville, NC $107.71 $16.53 – $1,091 785,186 213
Flint, MI $131.38 $26.80 – $190.89 778,751 30
Anchorage, AK $225.47 $0.00 – $457.51 774,379 149

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.