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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
Berkeley Heights, NJ $70.90 $24.68 – $163.52 44,111 29
Lake City, SC $37.68 $31.43 – $60.37 44,059 5
Niceville, FL $55.98 $29.22 – $80.37 44,049 8
Easton, MD $97.53 $30.96 – $147.04 43,970 15
South Haven, MI $140.71 $140.71 – $140.71 43,922 1
Luray, VA $192.27 $11.05 – $277.89 43,886 7
Detroit Lakes, MN $156.40 $50.68 – $228.49 43,836 25
Osage Beach, MO $110.50 $42.84 – $243.20 43,830 20
Winchester, MA $170.08 $36.23 – $195.10 43,772 18
Saint John, IN $115.96 $62.95 – $142.35 43,751 8
Hackettstown, NJ $180.88 $14.32 – $247.42 43,644 12
Hays, KS $56.09 $34.95 – $130.68 43,609 11
Keyser, WV $91.79 $54.87 – $203.73 43,563 10
Wadsworth, OH $80.00 $68.54 – $95.28 43,477 7
Downers Grove, IL $74.43 $29.97 – $157.79 43,407 32
London, OH $88.81 $44.79 – $119.80 43,332 9
Crystal City, MO $142.06 $125.24 – $151.81 43,294 7
Amsterdam, NY $110.78 $22.19 – $119.65 43,285 6
Sahuarita, AZ $134.30 $68.85 – $184.90 43,248 5
Tomah, WI $149.87 $17.20 – $170.52 43,221 11
Marlette, MI $127.81 $53.95 – $193.30 43,219 2
Shenandoah, TX $170.07 $46.39 – $403.42 43,201 28
Falmouth, MA $124.22 $34.65 – $204.71 43,197 30
Prairieville, LA $97.51 $37.47 – $255.26 43,165 15
Pearisburg, VA $157.86 $51.30 – $228.67 43,163 9
Baker City, OR $155.77 $97.78 – $291.76 43,140 12
Coon Rapids, MN $148.95 $36.72 – $184.86 43,118 23
Saint Johns, MI $152.68 $61.47 – $231.14 43,047 2
Mc Dowell, KY $228.02 $43.06 – $262.11 42,996 4
Newport, WA $156.21 $34.78 – $234.19 42,971 8
Van Wert, OH $93.49 $53.04 – $146.08 42,945 9
Hermiston, OR $145.46 $22.06 – $192.75 42,943 11
Belpre, OH $100.13 $84.21 – $115.93 42,878 6
Grundy, VA $120.24 $54.31 – $131.73 42,778 3
Susanville, CA $64.28 $0.00 – $78.80 42,748 17
Stockbridge, GA $79.15 $48.73 – $120.52 42,735 18
Logan, OH $90.51 $40.07 – $155.58 42,702 18
Manati, PR $42.73 $0.63 – $198.71 42,643 30
Delta, CO $103.58 $68.07 – $221.47 42,632 13
Kaplan, LA $94.67 $80.92 – $106.84 42,613 3
Sedona, AZ $93.58 $51.53 – $153.21 42,518 10
Reed City, MI $198.87 $198.87 – $198.87 42,504 1
Geneva, OH $103.37 $44.50 – $139.48 42,494 10
Lake City, FL $60.12 $7.17 – $83.20 42,471 23
North Conway, NH $134.61 $25.19 – $378.40 42,464 20
Zeeland, MI $159.41 $128.52 – $167.83 42,331 2
Parsippany, NJ $76.04 $43.29 – $119.16 42,310 23
Brighton, CO $110.30 $0.31 – $123.35 42,301 11
Westmont, IL $67.48 $40.60 – $170.95 42,247 17
Rhinelander, WI $45.66 $18.42 – $172.02 42,208 15

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.