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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
Bremerton, WA $63.00 $0.00 – $118.48 46,264 24
Saint Charles, MO $120.33 $19.84 – $400.01 46,226 20
Princeton, MN $159.70 $63.92 – $242.98 46,197 17
Fortuna, CA $118.28 $0.00 – $145.30 46,168 10
Poway, CA $198.91 $33.28 – $243.68 46,133 6
Kerrville, TX $186.79 $59.06 – $249.69 46,078 14
Omak, WA $176.70 $31.22 – $207.33 46,069 6
Ironwood, MI $111.46 $22.00 – $114.28 46,067 4
Pompano Beach, FL $75.25 $50.99 – $81.07 45,939 11
West Bend, WI $44.60 $22.35 – $51.39 45,908 9
Thomasville, NC $108.35 $53.29 – $196.28 45,669 15
Edenton, NC $100.71 $49.17 – $129.65 45,666 10
North Little Rock, AR $59.17 $26.38 – $134.98 45,565 25
Dunkirk, NY $137.10 $35.34 – $164.26 45,497 10
Kernersville, NC $105.05 $41.28 – $173.21 45,476 16
Wesley Chapel, FL $71.28 $4.89 – $354.58 45,466 26
Wareham, MA $167.97 $34.66 – $211.82 45,401 5
Twin Falls, ID $82.44 $37.10 – $151.41 45,400 13
Scottsburg, IN $93.15 $49.72 – $103.03 45,358 4
Bennington, VT $54.29 $22.17 – $154.59 45,347 22
Pulaski, TN $80.19 $63.17 – $159.86 45,335 5
Franklin, NC $135.86 $95.02 – $180.83 45,258 8
New London, WI $126.82 $17.26 – $188.14 45,248 16
Denham Springs, LA $88.83 $48.77 – $166.53 45,183 9
West Chester, OH $86.99 $22.49 – $179.79 45,171 17
Deming, NM $226.97 $54.79 – $236.89 45,060 6
Madison, IN $81.98 $28.93 – $151.28 45,046 17
Allen, TX $89.33 $22.81 – $247.60 45,003 29
Newport, VT $27.43 $18.38 – $84.30 44,968 8
Richardson, TX $116.34 $27.28 – $298.94 44,956 21
Tehachapi, CA $271.22 $42.09 – $351.31 44,806 8
Muskogee, OK $136.00 $53.25 – $379.27 44,802 21
Versailles, KY $139.13 $55.57 – $179.34 44,776 4
Waterville, ME $114.07 $12.48 – $150.96 44,747 17
Fort Stewart, GA $92.72 $14.43 – $126.56 44,737 29
The Dalles, OR $144.40 $26.52 – $192.73 44,705 14
Anacortes, WA $83.01 $50.95 – $118.40 44,696 9
Old Bridge, NJ $232.71 $19.65 – $281.91 44,690 7
Astoria, NY $97.66 $34.95 – $134.85 44,666 28
Parker, AZ $157.82 $41.84 – $264.33 44,657 17
Monroeville, AL $59.37 $30.56 – $153.74 44,630 10
Jennings, LA $73.08 $41.76 – $136.88 44,593 6
Seguin, TX $118.79 $0.00 – $183.69 44,582 13
Turnersville, NJ $72.57 $0.00 – $259.97 44,571 20
Marysville, MI $56.34 $56.34 – $56.34 44,528 1
Lompoc, CA $75.70 $7.48 – $124.75 44,486 11
Chardon, OH $91.72 $2.42 – $165.57 44,468 12
Hartford, KY $184.13 $50.55 – $187.08 44,386 2
Pontotoc, MS $146.48 $12.69 – $181.32 44,281 5
New Milford, CT $213.25 $15.83 – $248.19 44,262 8

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.