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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
Alabaster, AL $61.47 $0.00 – $95.74 87,877 18
Fort Sam Houston, TX $109.64 $22.84 – $252.29 87,848 62
Grenada, MS $94.34 $26.04 – $118.42 87,691 12
Rochester, NH $84.44 $1.66 – $135.43 87,544 15
Enterprise, AL $54.43 $23.94 – $133.03 87,395 18
Hendersonville, NC $113.03 $17.90 – $187.05 87,381 47
Murray, KY $154.61 $26.84 – $227.30 87,229 10
Palo Alto, CA $68.30 $0.00 – $413.52 87,160 98
Manning, SC $38.06 $28.36 – $77.85 87,152 13
Lebanon, KY $173.03 $59.68 – $243.33 87,131 4
Northport, AL $45.49 $16.71 – $96.49 87,107 15
Hinsdale, IL $61.80 $32.39 – $95.89 86,822 27
Lake Forest, IL $72.26 $26.95 – $137.59 86,732 32
Gresham, OR $141.92 $2.76 – $285.08 86,688 22
Sierra Vista, AZ $211.06 $36.43 – $265.30 86,499 16
Portland, IN $104.51 $58.62 – $109.78 86,389 8
Chester, PA $124.13 $0.74 – $247.38 86,311 37
Campbellsville, KY $100.56 $21.99 – $120.20 86,190 10
Lawrenceburg, TN $65.40 $20.06 – $190.56 86,183 7
Whiteville, NC $121.11 $53.90 – $210.77 86,134 15
Gig Harbor, WA $87.91 $58.90 – $93.58 85,941 15
Chester, SC $61.03 $31.34 – $158.39 85,792 10
Emporia, VA $120.18 $46.82 – $159.32 85,787 8
Front Royal, VA $138.13 $55.80 – $184.54 85,660 11
Asheboro, NC $146.21 $20.05 – $340.58 85,587 14
Montclair, CA $73.46 $37.74 – $161.83 85,255 15
Langhorne, PA $134.87 $28.08 – $316.37 85,020 28
Broken Arrow, OK $137.65 $71.77 – $196.22 85,006 17
Laconia, NH $111.03 $8.50 – $163.03 84,953 31
Dillon, SC $32.58 $24.99 – $173.93 84,907 10
Montebello, CA $60.36 $21.98 – $107.80 84,570 14
Redwood City, CA $92.98 $0.15 – $192.67 84,442 30
Lake Havasu City, AZ $150.14 $35.76 – $377.25 84,304 19
Flowood, MS $93.47 $8.84 – $114.56 84,256 11
Sebring, FL $68.14 $30.73 – $119.43 84,032 20
Fort Walton Beach, FL $62.71 $0.00 – $115.35 83,812 39
Mayfield Hts, OH $108.88 $51.18 – $169.66 83,768 9
Cortez, CO $92.54 $11.36 – $130.02 83,762 19
Lincoln City, OR $152.58 $49.57 – $283.75 83,692 21
North Miami Beach, FL $73.30 $0.00 – $98.79 83,620 29
Newton, NJ $234.01 $12.59 – $292.07 83,538 13
La Porte, IN $108.37 $34.14 – $132.39 83,450 12
Shawnee, OK $149.42 $22.10 – $226.20 83,429 19
Valencia, CA $71.56 $20.63 – $137.66 83,418 22
Booneville, MS $73.97 $15.41 – $118.27 83,399 8
Lewistown, PA $84.64 $34.85 – $167.89 83,358 20
Abilene, TX $133.80 $16.97 – $371.82 82,993 41
Clinton, SC $39.83 $14.63 – $67.80 82,977 10
Florissant, MO $154.50 $22.34 – $575.25 82,935 17
Pocatello, ID $88.80 $40.14 – $236.93 82,836 28

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.