Skip to content
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
Loxahatchee, FL $91.29 $42.33 – $179.88 50,852 11
Abington, PA $112.96 $38.70 – $198.99 50,807 35
Madison, AL $47.94 $17.60 – $67.91 50,676 19
Yukon, OK $144.52 $60.04 – $190.61 50,596 15
Summit, WI $48.76 $23.54 – $85.38 50,561 17
Carthage, MS $97.12 $13.68 – $114.69 50,518 7
Mooresville, NC $75.72 $25.40 – $174.52 50,485 23
Mesquite, TX $109.77 $12.89 – $203.69 50,480 19
Rogers, AR $60.67 $25.74 – $383.44 50,477 25
Greencastle, IN $81.53 $37.23 – $135.01 50,457 7
Mount Kisco, NY $125.03 $37.26 – $176.63 50,417 19
Mcalester, OK $127.26 $74.08 – $233.20 50,413 12
Mt Pleasant, SC $57.74 $36.60 – $98.70 50,384 9
Olean, NY $174.22 $24.64 – $203.91 50,354 8
Olathe, KS $68.68 $26.18 – $411.98 50,211 38
Encino, CA $49.51 $39.46 – $109.61 50,136 16
Mountain Home, AR $57.35 $35.62 – $159.96 50,127 23
Mountain View, CA $55.03 $0.00 – $156.94 50,063 33
Brighton, MA $74.21 $24.61 – $126.17 49,984 32
East Stroudsburg, PA $121.03 $0.00 – $165.85 49,927 15
South Miami, FL $77.33 $0.00 – $194.74 49,812 51
Varnville, SC $73.08 $36.69 – $127.21 49,777 2
Morganton, NC $108.35 $26.59 – $324.66 49,555 21
Lucedale, MS $64.64 $16.42 – $84.96 49,547 12
Chesterfield, MO $113.69 $16.62 – $427.66 49,522 40
Tazewell, VA $116.17 $48.72 – $151.45 49,460 9
Sparks, NV $90.03 $0.00 – $205.67 49,316 30
Barberton, OH $77.28 $41.01 – $150.44 49,242 14
Franklinton, LA $110.24 $37.74 – $220.55 49,145 7
Beaver Dam, WI $44.49 $22.97 – $123.04 49,137 13
Fort Atkinson, WI $53.41 $12.15 – $222.10 49,098 12
Jackson, OH $94.81 $50.48 – $154.36 48,997 6
Simpsonville, SC $30.24 $12.34 – $133.01 48,944 5
Medina, OH $89.31 $37.10 – $113.89 48,894 15
Fairfax, SC $33.83 $20.05 – $65.89 48,829 3
Rexburg, ID $96.77 $42.92 – $454.28 48,771 12
Austell, GA $86.90 $32.97 – $113.68 48,753 23
Va Beach, VA $68.27 $44.48 – $93.81 48,750 14
Nags Head, NC $94.75 $44.77 – $180.66 48,747 14
Luling, LA $104.16 $49.57 – $240.70 48,746 9
West Plains, MO $101.70 $37.46 – $130.87 48,737 14
Cass City, MI $123.79 $69.39 – $227.67 48,716 5
Wiggins, MS $71.47 $31.12 – $151.15 48,521 9
Flemington, NJ $209.85 $39.47 – $268.10 48,508 18
Newton, MA $141.52 $33.94 – $183.32 48,477 18
Thousand Oaks, CA $121.27 $10.64 – $263.82 48,434 26
Paw Paw, MI $161.66 $161.66 – $161.66 48,390 1
Canon City, CO $105.50 $59.68 – $183.92 48,378 11
Colville, WA $167.42 $25.31 – $190.44 48,317 10
Austin, MN $208.91 $81.31 – $300.20 48,291 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.