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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
Lihue, HI $348.29 $2.88 – $510.39 62,966 14
Merrillville, IN $97.51 $27.59 – $177.14 62,956 18
Lebanon, TN $117.54 $0.00 – $259.73 62,947 17
Bartlesville, OK $117.43 $41.25 – $256.04 62,928 21
Rutland, VT $51.75 $0.00 – $193.38 62,861 28
Webster, TX $141.64 $24.60 – $628.00 62,747 44
Lenoir, NC $120.83 $44.93 – $230.89 62,663 13
Russell Springs, KY $120.65 $41.44 – $143.77 62,632 5
Farmington, MO $132.07 $32.55 – $401.51 62,493 15
Tulare, CA $48.87 $13.89 – $113.30 62,466 12
Kinston, NC $77.12 $40.30 – $202.42 62,443 19
Plainsboro, NJ $320.09 $12.48 – $363.57 62,326 14
Madison, WV $108.69 $38.52 – $204.74 62,296 6
Woodland Hills, CA $288.45 $0.00 – $447.15 62,267 26
Largo, FL $68.70 $2.46 – $203.84 62,206 32
Fort Dodge, IA $118.97 $41.02 – $201.34 62,111 15
Manteca, CA $257.93 $7.96 – $343.51 62,043 19
Frisco, TX $151.69 $26.62 – $360.42 62,021 37
Vacaville, CA $183.01 $0.15 – $892.14 62,018 34
El Dorado, AR $63.46 $0.50 – $93.96 61,837 18
Orange City, FL $74.58 $13.97 – $317.14 61,824 24
Bluefield, WV $101.58 $36.17 – $165.50 61,754 16
Lewisville, TX $113.51 $63.99 – $171.71 61,752 17
Enumclaw, WA $240.82 $58.04 – $427.36 61,607 10
Mount Pleasant, WI $52.13 $16.82 – $123.15 61,592 21
Herrin, IL $52.48 $34.23 – $83.19 61,459 11
Burlington, WI $48.14 $22.55 – $84.06 61,331 23
Globe, AZ $326.56 $17.22 – $378.65 61,308 9
Weston, WI $45.38 $16.16 – $161.59 61,272 21
Conway, AR $45.06 $30.90 – $100.85 61,165 27
Jasper, TN $105.76 $58.60 – $134.80 61,120 7
Cottage Grove, OR $175.59 $74.36 – $235.48 60,883 13
Guaynabo, PR $74.74 $0.11 – $113.64 60,878 34
Bunkie, LA $91.76 $79.76 – $92.54 60,810 2
Moncks Corner, SC $78.02 $48.08 – $96.84 60,715 14
Port Jefferson, NY $144.34 $15.04 – $168.04 60,665 22
Clarksdale, MS $95.39 $0.61 – $305.43 60,642 12
Stanford, KY $118.12 $27.53 – $135.92 60,544 4
Hazlehurst, MS $115.42 $1.91 – $172.57 60,374 6
Papillion, NE $105.02 $47.85 – $159.12 60,364 13
Woodstock, VA $203.66 $43.77 – $243.60 60,277 6
Secaucus, NJ $199.25 $35.04 – $324.98 60,257 9
Plant City, FL $64.37 $13.14 – $208.97 60,249 19
Harris, NY $154.81 $31.67 – $171.58 60,240 6
Oregon City, OR $146.42 $43.83 – $250.09 60,232 13
Newberg, OR $224.98 $0.00 – $405.83 60,230 14
Lebanon, VA $124.12 $59.16 – $140.73 60,087 4
Placerville, CA $60.70 $6.96 – $133.99 60,050 15
Culver City, CA $72.07 $30.43 – $106.50 59,995 18
Coupeville, WA $199.98 $34.09 – $256.21 59,819 8

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.