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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
Many, LA $75.67 $22.42 – $203.89 48,279 11
La Plata, MD $102.86 $39.05 – $148.36 48,225 14
Franklin, IN $88.89 $26.32 – $106.91 48,093 11
Aguadilla, PR $45.91 $0.00 – $100.21 48,037 19
Presque Isle, ME $144.67 $2.70 – $179.05 48,032 12
Winfield, AL $49.45 $18.50 – $88.63 48,028 6
Bremen, GA $143.14 $55.94 – $154.72 48,019 5
Cheektowaga, NY $135.96 $22.07 – $175.47 47,974 12
Oneonta, NY $162.90 $10.30 – $188.04 47,968 7
Truth Or Consequences, NM $214.80 $99.44 – $341.94 47,937 4
El Centro, CA $75.70 $0.10 – $104.84 47,915 17
Dorchester, MA $99.48 $44.90 – $394.35 47,895 10
Sleepy Hollow, NY $145.28 $37.92 – $308.16 47,736 19
Gaylord, MI $147.17 $51.27 – $152.89 47,671 4
Mcminnville, TN $95.76 $5.41 – $129.79 47,656 19
Hardeeville, SC $42.26 $37.37 – $83.14 47,656 8
Searcy, AR $76.67 $0.59 – $157.39 47,579 22
Fishers, IN $102.59 $35.48 – $160.04 47,538 22
Linton, IN $83.40 $24.93 – $90.05 47,520 9
Camp Hill, PA $149.26 $31.66 – $209.35 47,515 31
Newark, NY $134.50 $58.12 – $271.87 47,433 14
Huron, SD $29.44 $27.69 – $102.64 47,346 7
Coos Bay, OR $91.33 $31.01 – $357.59 47,281 19
Harvey, LA $129.24 $82.95 – $207.55 47,274 10
Lufkin, TX $122.50 $9.92 – $192.29 47,265 16
Vero Beach, FL $66.30 $7.09 – $114.51 47,259 29
Suffern, NY $172.69 $24.93 – $181.66 47,238 8
Ahoskie, NC $97.37 $49.44 – $116.84 47,237 7
West Valley City, UT $45.57 $24.91 – $252.04 47,226 11
Benton, KY $109.47 $32.20 – $196.15 47,212 12
Carrollton, KY $118.58 $50.33 – $154.16 47,176 5
Breaux Bridge, LA $104.37 $53.62 – $127.49 47,115 8
Socorro, NM $222.88 $29.67 – $276.43 47,079 7
Livingston, TN $81.69 $41.22 – $255.33 47,056 6
Gloversville, NY $112.47 $22.67 – $125.05 46,932 9
Sun City, CA $60.68 $53.40 – $93.27 46,901 3
Oneida, NY $114.89 $41.99 – $126.53 46,849 12
Westminster, CA $59.05 $0.00 – $115.32 46,814 13
Clyde, NC $94.72 $51.80 – $406.45 46,745 10
Bay Saint Louis, MS $156.27 $156.27 – $156.27 46,745 1
Indiana, PA $77.78 $44.35 – $291.35 46,720 16
Wynnewood, PA $122.14 $36.64 – $969.32 46,708 26
Orem, UT $48.96 $24.36 – $175.91 46,635 15
Ephrata, PA $114.31 $49.79 – $398.97 46,599 25
Monroe, WA $106.07 $38.87 – $113.23 46,548 8
Berlin, VT $51.33 $0.97 – $106.14 46,538 16
Baraboo, WI $58.48 $11.83 – $60.20 46,535 6
Nampa, ID $83.01 $25.50 – $181.52 46,444 21
Rolla, MO $129.39 $68.58 – $387.00 46,351 22
Alhambra, CA $52.16 $9.51 – $492.42 46,334 25

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.