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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
Eaton Rapids, MI $125.98 $125.98 – $125.98 37,374 1
Dallas, OR $167.40 $155.75 – $214.59 37,363 4
Dulles, VA $136.51 $51.99 – $181.56 37,347 4
Claremont, NH $119.93 $53.21 – $176.69 37,328 6
Othello, WA $168.89 $40.06 – $214.38 37,289 5
Laurel, MD $111.33 $23.41 – $175.96 37,249 21
Kotzebue, AK $125.92 $40.55 – $187.00 37,249 6
St Louis Park, MN $169.21 $23.29 – $319.92 37,210 40
Palos Heights, IL $68.73 $13.52 – $169.68 37,155 24
Plymouth, IN $112.19 $78.16 – $208.29 37,147 5
Watertown, WI $50.83 $14.77 – $51.20 37,122 5
Price, UT $49.95 $15.79 – $273.47 37,112 13
St. Louis, MO $104.10 $17.85 – $602.90 37,096 27
Union City, TN $94.81 $51.82 – $207.02 37,078 9
Carlisle, PA $84.19 $60.20 – $189.91 37,020 12
Raeford, NC $82.29 $60.48 – $107.11 37,005 11
Atlantis, FL $65.41 $13.67 – $311.96 36,958 33
Bellefontaine, OH $93.08 $29.87 – $118.18 36,884 8
Wooster, OH $95.38 $28.32 – $125.56 36,850 6
Harrison, AR $81.80 $0.23 – $193.88 36,834 18
Alturas, CA $143.95 $1.23 – $170.32 36,828 3
Silvis, IL $107.66 $44.70 – $253.09 36,652 12
Bonne Terre, MO $125.39 $39.18 – $138.16 36,607 5
Antigo, WI $132.15 $45.78 – $149.16 36,600 7
Houston, MO $135.88 $52.88 – $206.41 36,555 9
North Vernon, IN $83.19 $42.75 – $103.14 36,510 5
Denison, TX $127.03 $36.08 – $182.54 36,448 17
Natrona Heights, PA $104.14 $11.18 – $125.38 36,435 11
Bath, NY $81.37 $12.38 – $128.07 36,430 3
New Martinsville, WV $91.37 $36.40 – $138.13 36,344 9
Irvine, CA $77.90 $49.28 – $186.61 36,332 40
Port Jervis, NY $173.75 $38.06 – $221.84 36,281 5
Bastrop, LA $135.72 $44.74 – $230.16 36,262 10
Canandaigua, NY $149.07 $44.24 – $161.32 36,093 6
Washington, PA $96.94 $5.53 – $203.43 36,050 17
Aberdeen, SD $78.36 $21.51 – $128.58 36,050 13
Midwest City, OK $150.39 $60.07 – $177.22 36,036 12
Canton, TX $104.40 $48.34 – $154.39 36,012 18
Blairsville, GA $144.35 $53.44 – $173.47 36,009 12
Shelbyville, IN $57.70 $7.06 – $92.93 36,000 17
Truckee, CA $78.23 $35.90 – $132.27 35,993 17
Cedar Falls, IA $133.64 $37.75 – $214.78 35,946 10
Abbeville, LA $116.87 $48.91 – $157.26 35,875 7
Rockingham, VA $75.50 $36.10 – $323.10 35,874 18
Natchitoches, LA $95.37 $45.50 – $141.12 35,838 21
Ketchikan, AK $329.83 $0.00 – $418.45 35,813 13
Pullman, WA $225.15 $34.87 – $249.91 35,804 8
Lewiston, NY $152.16 $48.76 – $152.51 35,761 3
Jefferson Hills, PA $93.15 $0.00 – $117.61 35,728 15
Oak Grove, LA $59.71 $49.84 – $86.44 35,587 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.