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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
Skokie, IL $63.82 $28.40 – $141.89 42,083 21
Bentonville, AR $78.20 $2.30 – $127.79 42,077 18
Seminole, OK $156.76 $92.82 – $191.09 42,061 6
Lincolnton, NC $131.31 $0.00 – $196.67 41,967 15
Melrose Park, IL $59.74 $31.78 – $140.72 41,909 25
Lexington, MS $98.64 $20.84 – $111.42 41,803 4
Greensboro, GA $62.77 $62.30 – $71.96 41,797 2
Jackson, CA $75.11 $0.00 – $164.63 41,791 8
Boca Raton, FL $67.71 $0.00 – $197.52 41,767 70
Warner Robins, GA $77.93 $36.53 – $99.79 41,724 24
West Jordan, UT $21.79 $13.45 – $151.75 41,666 13
Winfield, IL $68.46 $23.61 – $128.44 41,652 30
Ellenville, NY $240.25 $60.95 – $325.06 41,631 3
Kenmore, NY $158.59 $36.90 – $180.02 41,625 7
Kirksville, MO $116.40 $49.21 – $195.08 41,580 11
Scottsbluff, NE $107.29 $55.56 – $386.02 41,535 13
Ashland, OH $93.67 $35.99 – $126.37 41,503 7
Ashland, WI $136.39 $23.70 – $164.19 41,457 6
Polson, MT $58.08 $11.36 – $160.11 41,370 15
Arecibo, PR $38.32 $2.52 – $101.32 41,294 38
Grass Valley, CA $81.02 $0.00 – $638.72 41,251 21
Carson City, MI $112.98 $57.74 – $170.41 41,231 2
Rowlett, TX $98.89 $64.64 – $120.87 41,117 11
Sheffield, AL $66.14 $27.10 – $131.56 41,056 12
Sonoma, CA $82.90 $0.00 – $117.46 41,051 17
Tallassee, AL $52.69 $24.46 – $84.21 40,965 4
Prince Frederick, MD $83.78 $19.87 – $174.04 40,872 19
Murrells Inlet, SC $43.57 $30.44 – $80.19 40,855 10
Bryan, OH $87.00 $38.84 – $147.81 40,851 9
Troy, AL $41.52 $25.83 – $44.39 40,765 12
Amery, WI $154.53 $28.30 – $340.26 40,690 25
Angola, IN $118.57 $47.37 – $568.45 40,683 7
Coronado, CA $238.24 $42.26 – $421.67 40,675 9
Wahiawa, HI $360.09 $0.00 – $385.59 40,657 3
Medford, MA $185.19 $27.33 – $207.93 40,607 11
La Grande, OR $208.66 $66.02 – $252.54 40,570 9
Pleasant Hill, MO $117.95 $117.95 – $117.95 40,458 1
Pawtucket, RI $80.26 $49.83 – $474.53 40,451 13
Liberty, MO $117.54 $37.31 – $332.76 40,433 19
North Richland Hills, TX $124.17 $26.99 – $397.59 40,328 17
Abbeville, SC $27.45 $15.71 – $70.52 40,273 6
Sylva, NC $101.38 $58.81 – $548.66 40,232 11
Berlin, NH $82.22 $41.64 – $153.14 40,139 6
Port Arthur, TX $85.83 $32.09 – $123.89 40,120 19
New Port Richey, FL $91.34 $2.42 – $297.56 40,097 20
Killeen, TX $111.24 $43.64 – $205.86 40,042 21
Fremont, OH $98.65 $41.56 – $127.09 40,009 5
Libertyville, IL $64.40 $26.31 – $132.10 39,984 20
Ridgecrest, CA $72.76 $35.46 – $88.23 39,938 13
Ronan, MT $39.08 $9.39 – $121.20 39,836 14

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.