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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
Daly City, CA $68.48 $8.62 – $254.12 57,018 23
Milford, MA $139.16 $5.03 – $180.07 56,976 22
Roosevelt, UT $69.74 $38.91 – $200.01 56,906 11
Travis Afb, CA $79.69 $14.20 – $164.08 56,890 37
Newburgh, IN $92.11 $33.27 – $222.06 56,743 21
Harriman, TN $98.79 $54.93 – $311.54 56,690 10
Pearland, TX $120.37 $32.22 – $289.50 56,547 22
Ionia, MI $170.06 $57.85 – $226.34 56,402 2
Sunnyvale, TX $86.18 $33.50 – $304.66 56,389 15
Tawas City, MI $130.01 $77.71 – $149.29 56,372 3
Oroville, CA $58.66 $0.00 – $730.88 56,319 18
El Segundo, CA $61.24 $19.89 – $80.90 56,288 10
Blue Island, IL $61.08 $35.70 – $171.57 56,282 13
Fairmont, WV $107.25 $50.98 – $303.46 56,270 12
Greeneville, TN $93.18 $10.42 – $158.08 56,230 16
Batavia, NY $122.45 $46.23 – $144.27 56,079 14
Ithaca, NY $140.66 $42.40 – $162.63 55,803 17
Mt Pleasant, MI $155.42 $94.53 – $241.12 55,723 3
Rio Rancho, NM $156.64 $72.56 – $179.13 55,648 13
Hollister, CA $67.13 $2.38 – $78.01 55,634 8
Cortlandt Manor, NY $142.42 $39.39 – $175.93 55,476 9
Rome, NY $131.56 $53.65 – $136.45 55,449 6
Fairhope, AL $74.00 $35.55 – $137.55 55,397 17
Oro Valley, AZ $135.14 $56.43 – $149.59 55,286 6
Altus, OK $142.93 $84.66 – $228.94 55,273 11
Taos, NM $199.76 $81.43 – $269.89 55,199 8
Juneau, AK $267.27 $44.07 – $329.69 55,194 16
Ada, OK $154.30 $17.53 – $198.75 55,166 31
Gettysburg, PA $109.26 $18.97 – $270.36 55,163 23
Hartford, WI $62.64 $20.09 – $154.01 55,079 21
Lewiston, ID $69.45 $29.06 – $124.64 55,045 25
Washington, NC $98.67 $51.34 – $215.79 55,023 18
Machias, ME $13.55 $12.13 – $93.82 54,971 5
Marshall, MI $158.49 $72.48 – $183.59 54,903 6
Ridgewood, NJ $255.05 $27.63 – $301.78 54,793 21
Weslaco, TX $133.81 $43.12 – $603.75 54,787 20
Paris, KY $190.06 $60.33 – $241.93 54,745 6
Cheyenne, WY $101.85 $2.11 – $173.67 54,483 37
Damariscotta, ME $15.42 $14.49 – $142.80 54,127 3
Union, SC $49.10 $46.17 – $65.08 54,118 3
Woonsocket, RI $66.94 $38.20 – $189.82 54,055 20
Geneva, NY $109.17 $59.27 – $152.40 54,031 12
Smyrna, GA $64.06 $34.30 – $82.33 54,002 12
Gilroy, CA $74.08 $4.07 – $93.21 53,953 10
Fort Bragg, CA $125.21 $0.00 – $527.27 53,930 12
Albemarle, NC $113.26 $46.95 – $445.33 53,866 19
Lebanon, MO $143.20 $33.67 – $401.63 53,668 18
Denton, TX $91.32 $6.58 – $151.30 53,620 31
Rochester, MI $148.06 $62.77 – $211.80 53,592 5
Low Moor, VA $130.64 $44.04 – $149.21 53,523 4

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.