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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
Bucyrus, OH $85.33 $62.45 – $128.86 93,629 11
Dekalb, IL $60.76 $23.23 – $222.64 93,550 31
Harbor City, CA $358.90 $6.00 – $503.02 93,508 22
Auburn, NY $122.65 $42.75 – $155.01 93,387 20
Weirton, WV $135.15 $34.90 – $160.21 93,355 13
Richlands, VA $123.21 $77.99 – $138.82 93,214 6
Prosser, WA $193.69 $45.06 – $249.02 93,191 6
Bel Air, MD $70.34 $21.62 – $177.49 93,056 40
Steubenville, OH $100.76 $34.53 – $168.95 92,686 22
Seneca, SC $37.18 $17.00 – $83.74 92,374 15
Dover, NH $124.44 $10.78 – $326.91 92,361 26
High Point, NC $141.41 $59.28 – $460.20 92,261 38
Sayre, PA $91.67 $54.48 – $153.18 92,254 37
Portsmouth, NH $199.28 $4.35 – $238.79 92,226 23
Independence, LA $120.88 $44.50 – $257.99 92,117 8
Somerville, NJ $277.89 $41.60 – $320.26 92,061 16
Port Angeles, WA $91.49 $25.77 – $258.80 91,997 25
Glen Burnie, MD $87.32 $31.54 – $275.01 91,950 44
Jasper, IN $92.35 $45.15 – $112.54 91,847 21
Alameda, CA $62.70 $0.00 – $105.90 91,710 15
Harlan, KY $215.92 $29.70 – $300.84 91,633 12
Findlay, OH $99.96 $1.98 – $189.37 91,517 23
Huntington, NY $139.79 $30.21 – $178.36 91,456 41
Martin, TN $105.71 $52.58 – $237.72 91,454 10
Johnson City, NY $90.11 $0.00 – $249.94 91,076 52
Circleville, OH $93.22 $26.90 – $119.81 91,003 16
San Mateo, CA $59.55 $0.23 – $90.08 90,910 26
Shelbyville, KY $141.54 $38.41 – $231.16 90,906 19
Independence, MO $116.23 $0.00 – $591.30 90,810 47
Kankakee, IL $69.07 $25.05 – $147.96 90,701 20
Ames, IA $119.72 $25.30 – $178.12 90,245 25
Willoughby, OH $99.42 $19.95 – $142.04 90,158 24
Morehead City, NC $75.74 $52.81 – $122.79 90,024 14
Lebanon, NH $109.00 $14.45 – $328.29 90,023 101
West Hollywood, CA $89.20 $0.00 – $270.14 90,011 76
Mason City, IA $114.20 $13.81 – $1,750 89,920 29
South Williamson, KY $139.19 $43.18 – $178.10 89,919 9
Prosper, TX $138.46 $43.75 – $553.66 89,749 21
Marquette, MI $113.23 $59.67 – $181.71 89,658 6
Logan, WV $171.64 $7.02 – $468.70 89,522 16
Holmdel, NJ $195.96 $13.91 – $287.34 89,298 15
Durango, CO $110.93 $16.01 – $195.10 89,281 32
San Angelo, TX $94.66 $40.07 – $185.95 89,249 32
Lanham, MD $129.97 $3.09 – $163.14 88,561 32
Troy, OH $104.04 $37.08 – $155.07 88,506 18
Buckhannon, WV $121.37 $67.42 – $267.89 88,504 14
Weymouth, MA $70.58 $31.12 – $146.46 88,472 47
Stevens Point, WI $50.53 $16.74 – $117.44 88,359 20
Plattsburgh, NY $118.11 $15.05 – $180.78 88,317 26
Salina, KS $54.65 $27.54 – $154.55 88,176 23

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.