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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
Sonora, CA $67.28 $1.39 – $104.25 39,814 15
Benson, AZ $246.78 $36.92 – $340.54 39,582 7
Hilton Head Island, SC $77.66 $17.33 – $131.59 39,574 11
Spring Hill, FL $63.63 $11.15 – $146.42 39,502 24
Albany, KY $141.56 $41.97 – $189.32 39,416 7
Grayling, MI $163.17 $59.91 – $163.60 39,338 2
Las Vegas, NM $169.61 $56.64 – $240.81 39,277 5
Superior, WI $165.62 $137.41 – $165.89 39,274 3
St Cloud, MN $133.47 $60.82 – $722.14 39,214 16
Boscobel, WI $125.16 $36.89 – $159.51 39,205 11
Manitowoc, WI $52.49 $24.68 – $57.90 39,186 7
San Dimas, CA $50.37 $0.00 – $76.40 38,992 10
Spruce Pine, NC $119.08 $83.44 – $154.58 38,939 6
Lexington, VA $191.72 $45.24 – $235.90 38,834 9
Cumberland, MD $88.46 $39.99 – $231.67 38,824 28
Winchester, TN $86.55 $0.00 – $227.74 38,804 10
San Gabriel, CA $51.11 $21.80 – $74.08 38,782 14
South Lake Tahoe, CA $105.47 $40.44 – $227.64 38,772 23
Horse Cave, KY $201.70 $46.16 – $253.02 38,714 3
Sylvania, OH $78.43 $21.80 – $140.27 38,693 13
Weatherford, TX $91.85 $42.86 – $155.80 38,669 15
Wellsville, NY $126.13 $41.04 – $203.72 38,666 8
Southern Pines, NC $84.32 $58.28 – $171.88 38,644 7
Duncan, OK $145.70 $66.63 – $176.64 38,642 11
Warrensburg, MO $86.68 $62.35 – $122.99 38,619 9
Enid, OK $130.37 $50.89 – $183.26 38,615 18
Prattville, AL $71.68 $35.55 – $123.95 38,595 4
Louisville, MS $108.24 $7.86 – $124.17 38,541 7
Seaman, OH $67.43 $8.76 – $135.45 38,521 3
Milton, MA $176.49 $63.80 – $357.48 38,496 7
Edina, MN $185.32 $32.70 – $670.33 38,485 25
Portage, WI $56.54 $17.35 – $184.52 38,451 8
Ishpeming, MI $135.61 $134.68 – $152.12 38,437 2
Lewisburg, PA $75.50 $40.64 – $246.74 38,407 18
Mcminnville, OR $142.88 $78.66 – $201.81 38,370 7
Flemingsburg, KY $222.28 $35.95 – $269.33 38,344 4
Kermit, TX $68.82 $68.82 – $68.82 38,283 1
Sikeston, MO $114.76 $30.76 – $455.23 38,264 13
Cambridge, MD $85.78 $18.75 – $136.66 38,262 12
Baytown, TX $192.43 $23.89 – $993.21 38,253 35
Pottsville, PA $104.80 $21.62 – $195.11 38,252 16
Burley, ID $124.90 $49.84 – $187.60 38,219 11
Concord, CA $66.08 $0.00 – $146.81 38,174 24
Merrill, WI $115.06 $28.77 – $152.39 38,044 4
Coshocton, OH $76.34 $43.87 – $134.14 37,979 10
Ottumwa, IA $119.19 $6.48 – $1,010 37,857 14
Valdese, NC $104.53 $42.77 – $134.46 37,816 5
Eglin Afb, FL $74.60 $14.46 – $136.33 37,773 23
Rice Lake, WI $44.31 $23.94 – $88.33 37,427 10
Scottsville, KY $193.50 $36.57 – $235.19 37,374 4

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.