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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
Americus, GA $84.89 $35.62 – $102.82 82,815 12
Bayonne, NJ $120.51 $22.47 – $156.97 82,797 18
Carmel, IN $100.94 $23.36 – $210.35 82,666 49
Sugar Land, TX $148.39 $14.32 – $596.77 82,564 63
Saint Petersburg, FL $91.27 $25.64 – $276.67 82,405 27
Clinton Twp, MI $221.74 $70.11 – $224.33 82,322 5
Lakewood, CA $75.66 $36.97 – $111.10 82,269 17
Homestead, FL $83.27 $11.58 – $199.68 82,184 32
Michigan City, IN $91.31 $37.50 – $150.40 82,120 30
Belfast, ME $13.94 $0.11 – $94.49 81,988 7
Cape Coral, FL $80.50 $7.20 – $389.73 81,798 28
Beverly, MA $134.59 $20.16 – $1,613 81,789 29
Toppenish, WA $98.02 $0.00 – $103.69 81,771 5
Georgetown, SC $48.14 $32.25 – $155.59 81,767 24
Layton, UT $33.43 $18.71 – $169.01 81,673 14
Martinez, CA $32.18 $0.17 – $112.96 81,638 31
Chambersburg, PA $116.69 $18.35 – $328.64 81,432 29
Wellington, FL $69.68 $11.66 – $311.80 81,236 34
Bardstown, KY $136.42 $40.31 – $175.23 81,108 11
Hastings, MI $133.82 $54.89 – $234.81 81,042 7
Opelika, AL $46.71 $2.11 – $90.41 80,800 39
Summersville, WV $120.02 $44.65 – $438.13 80,749 15
Mount Airy, NC $87.22 $42.52 – $149.47 80,670 10
Encinitas, CA $74.39 $46.29 – $118.34 80,635 40
Cherry Hill, NJ $78.88 $36.76 – $145.97 80,266 24
Oxford, NC $112.07 $84.83 – $167.48 80,092 7
Christiansburg, VA $144.25 $37.01 – $168.05 79,975 17
Clovis, NM $183.73 $50.59 – $196.20 79,855 9
West Memphis, AR $100.60 $45.88 – $155.15 79,689 10
Surprise, AZ $149.17 $25.49 – $243.86 79,587 29
Crescent City, CA $109.78 $0.00 – $116.80 79,526 20
Berea, KY $151.56 $44.42 – $173.96 79,434 4
Jefferson, LA $137.31 $59.24 – $354.27 79,357 13
Mt Sterling, KY $129.76 $39.48 – $135.60 79,331 4
Beavercreek, OH $109.97 $33.07 – $171.60 79,314 24
Glens Falls, NY $112.05 $11.88 – $124.19 78,866 20
Fort Mohave, AZ $180.79 $60.97 – $222.40 78,579 9
Greensburg, PA $89.28 $44.84 – $373.08 78,502 23
Wytheville, VA $126.71 $53.74 – $144.98 78,486 7
Bethpage, NY $94.80 $58.15 – $152.22 77,960 13
Galax, VA $119.58 $50.08 – $138.63 77,880 7
Mandeville, LA $107.25 $32.38 – $165.06 77,841 17
Oak Ridge, TN $107.06 $0.00 – $195.11 77,770 18
Richmond Heights, OH $82.86 $1.25 – $132.60 77,751 14
Cleveland, MS $137.41 $19.57 – $158.70 77,569 6
Gonzales, LA $117.72 $23.05 – $285.78 77,521 24
Los Alamitos, CA $61.74 $20.90 – $100.35 77,439 26
Jefferson City, MO $119.12 $36.36 – $424.99 77,320 37
Minot, ND $150.77 $14.84 – $210.55 77,309 29
Watertown, NY $117.44 $24.41 – $150.42 77,183 20

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.