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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
Colton, CA $73.91 $6.15 – $435.56 773,559 158
Glendale, AZ $215.01 $9.47 – $322.50 769,456 103
Chattanooga, TN $109.38 $0.00 – $429.12 767,302 226
Little Rock, AR $76.73 $1.79 – $227.51 756,433 280
Providence, RI $92.98 $20.94 – $680.08 754,000 367
Worcester, MA $101.48 $0.00 – $254.29 753,637 356
Gainesville, FL $81.28 $0.00 – $454.12 751,230 336
Colorado Springs, CO $100.38 $0.00 – $289.91 748,042 274
Canton, OH $90.78 $6.84 – $251.00 740,307 145
Madison, WI $59.96 $9.09 – $346.16 734,593 263
Fayetteville, NC $99.27 $4.72 – $579.26 726,176 170
Salinas, CA $85.58 $8.29 – $167.46 703,028 75
Des Moines, IA $135.04 $11.60 – $1,751 702,067 223
Corpus Christi, TX $141.12 $0.00 – $356.76 697,472 228
Waterbury, CT $205.52 $0.00 – $315.59 669,710 98
Yakima, WA $82.45 $29.25 – $215.44 668,237 75
Mobile, AL $71.66 $0.00 – $291.73 658,803 229
Austin, TX $125.71 $0.00 – $1,136 658,275 385
Wichita, KS $61.55 $7.43 – $301.43 656,776 238
Ann Arbor, MI $133.47 $0.00 – $343.50 642,800 118
New Brunswick, NJ $217.38 $18.90 – $415.85 637,604 115
Allentown, PA $120.90 $0.00 – $515.70 630,031 208
Bloomington, MN $158.22 $12.61 – $396.26 628,191 229
Greensboro, NC $138.22 $0.00 – $658.90 627,113 200
Modesto, CA $82.65 $0.00 – $173.27 624,564 123
Hollywood, FL $75.37 $0.00 – $329.12 617,968 151
Jersey City, NJ $258.37 $16.88 – $402.20 617,176 89
Virginia Beach, VA $112.32 $30.25 – $329.32 613,621 166
Vancouver, WA $93.61 $31.06 – $360.89 611,712 104
Redding, CA $123.87 $0.00 – $826.26 610,646 133
Charleston, WV $127.35 $20.22 – $656.45 605,148 137
New Hyde Park, NY $158.57 $33.00 – $679.71 601,883 176
Monroe, LA $96.41 $11.45 – $317.03 600,206 108
Jackson, TN $94.97 $0.00 – $434.33 594,012 144
Stratford, NJ $246.41 $19.39 – $413.79 592,937 78
Erie, PA $80.44 $0.00 – $244.50 582,207 159
Hackensack, NJ $188.15 $15.62 – $332.38 581,932 199
Lancaster, CA $253.08 $16.88 – $466.72 577,590 55
New Britain, CT $195.43 $27.46 – $297.56 575,423 58
Voorhees, NJ $266.28 $14.85 – $386.48 572,433 59
Roanoke, VA $113.17 $21.30 – $304.22 568,599 183
Charlottesville, VA $131.46 $10.65 – $242.07 564,756 185
Temple, TX $124.56 $0.00 – $319.80 563,081 202
Peoria, IL $74.72 $29.72 – $1,130 561,795 161
Newark, DE $90.00 $5.25 – $285.02 560,932 182
Lake Charles, LA $92.64 $8.73 – $390.99 559,407 101
Livonia, MI $83.82 $29.59 – $263.45 555,726 29
Southfield, MI $68.59 $15.24 – $176.90 552,834 21
Morgantown, WV $113.42 $25.24 – $494.01 545,130 158
Muskegon, MI $105.47 $29.67 – $170.02 535,424 23

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.