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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
South El Monte, CA $51.87 $25.38 – $122.45 59,811 8
Niagara Falls, NY $112.95 $5.35 – $131.49 59,751 15
Bryan, TX $97.85 $3.48 – $316.98 59,677 39
Lafayette, CO $100.40 $15.15 – $184.40 59,656 19
Du Bois, PA $88.65 $0.21 – $269.95 59,529 26
Leesburg, FL $68.04 $30.95 – $323.75 59,483 23
Salem, NJ $245.53 $203.27 – $275.34 59,482 4
Plymouth, NH $119.47 $22.64 – $147.07 59,474 9
Willits, CA $110.86 $0.00 – $112.17 59,370 4
Payson, AZ $257.13 $59.78 – $369.00 59,337 12
Oxford, OH $92.09 $41.95 – $122.25 59,279 9
Irvine, KY $111.03 $41.16 – $128.01 59,222 3
Clarkston, WA $155.85 $31.74 – $208.66 59,111 8
Kenansville, NC $89.79 $48.81 – $206.51 59,048 10
Placentia, CA $70.97 $15.46 – $144.79 59,021 17
Batesville, AR $66.12 $0.00 – $95.59 58,889 16
Austintown, OH $83.41 $6.45 – $112.02 58,868 9
Ocoee, FL $72.49 $25.20 – $167.49 58,823 19
Barrington, IL $63.91 $49.68 – $215.91 58,663 23
Rockport, ME $144.41 $25.06 – $178.81 58,631 20
Joshua Tree, CA $58.10 $48.47 – $72.56 58,615 7
Katy, TX $163.34 $0.00 – $1,240 58,611 48
Covington, TN $83.12 $24.40 – $99.23 58,602 8
Caribou, ME $34.03 $24.79 – $92.93 58,488 8
Laguna Hills, CA $51.53 $9.85 – $114.42 58,477 19
Sedro Woolley, WA $417.72 $60.77 – $555.99 58,471 5
Hannibal, MO $110.45 $33.97 – $386.54 58,450 17
Chicago Ridge, IL $94.71 $30.35 – $137.31 58,323 20
Cordova, TN $89.68 $7.00 – $148.87 58,275 18
Burlingame, CA $71.62 $0.00 – $105.34 58,216 33
Caldwell, ID $130.63 $55.89 – $201.59 58,134 12
Kosciusko, MS $99.03 $10.30 – $116.14 58,040 4
Barstow, CA $63.05 $42.99 – $88.64 58,026 6
Phila, PA $170.79 $42.07 – $336.43 58,011 17
Greenville, MI $179.58 $10.70 – $180.67 57,923 3
Fort Payne, AL $53.88 $26.02 – $126.10 57,898 14
Fort Polk, LA $102.85 $52.70 – $312.69 57,764 13
Wisconsin Rapids, WI $50.14 $20.04 – $82.06 57,760 10
Kealakekua, HI $318.76 $61.59 – $399.60 57,723 7
Live Oak, TX $139.00 $0.00 – $421.63 57,716 19
Jber, AK $146.73 $34.63 – $197.10 57,638 20
Corning, NY $114.43 $64.72 – $131.20 57,624 8
Marina Del Rey, CA $56.84 $12.36 – $136.33 57,547 22
El Dorado, KS $67.71 $48.30 – $72.03 57,544 5
Greenwood, IN $90.55 $28.65 – $141.05 57,376 27
Cambridge, OH $90.64 $42.06 – $129.02 57,365 12
Calais, ME $32.81 $14.03 – $107.27 57,217 10
Brandon, MS $97.53 $18.55 – $120.57 57,093 9
Uniontown, PA $82.32 $47.24 – $137.74 57,038 23
Lexington, SC $74.27 $3.55 – $114.10 57,026 19

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.