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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
San Jose, CA $55.85 $0.00 – $577.83 533,312 191
Staten Island, NY $136.33 $19.73 – $242.31 532,721 181
Fredericksburg, VA $130.54 $29.21 – $182.79 532,656 69
Oak Lawn, IL $74.58 $9.42 – $318.76 520,722 211
St Petersburg, FL $102.37 $1.35 – $681.43 514,976 154
Edgewood, KY $152.51 $30.35 – $253.55 512,114 82
Vineland, NJ $291.26 $22.62 – $485.17 511,617 53
Wilmington, NC $138.32 $0.00 – $401.38 511,613 108
Springfield, MO $135.19 $9.43 – $707.57 508,754 223
Santa Rosa, CA $93.87 $0.00 – $910.70 505,118 161
Madera, CA $40.89 $0.00 – $492.58 493,699 58
Albany, NY $100.90 $7.46 – $208.80 490,144 168
Springfield, IL $69.78 $18.10 – $432.50 490,116 171
Long Beach, CA $66.90 $0.00 – $335.38 488,108 112
Flushing, NY $116.06 $14.86 – $795.71 487,528 135
Lynchburg, VA $108.68 $13.07 – $160.13 486,853 98
Newport, TN $72.28 $36.69 – $135.76 484,892 13
Wyandotte, MI $127.92 $20.04 – $262.79 484,509 38
Spartanburg, SC $59.48 $28.59 – $177.14 484,153 108
Huntington, WV $107.13 $29.32 – $591.60 476,090 103
Hattiesburg, MS $121.47 $7.37 – $286.08 475,588 94
Scottsdale, AZ $153.07 $13.34 – $267.27 470,418 197
Metairie, LA $102.44 $0.00 – $401.98 469,812 71
Billings, MT $62.18 $0.00 – $248.74 468,707 69
Farmington Hills, MI $126.96 $35.85 – $246.46 467,772 45
Saint Joseph, MI $115.50 $0.00 – $271.49 466,205 39
Augusta, GA $86.72 $22.14 – $217.51 458,179 196
Montgomery, AL $56.31 $0.00 – $130.30 458,036 133
Chapel Hill, NC $120.58 $20.11 – $366.23 452,177 207
Pueblo, CO $95.35 $0.00 – $225.78 452,056 86
Las Cruces, NM $136.82 $2.54 – $323.84 452,007 72
Durham, NC $105.90 $0.00 – $533.96 448,598 242
Florence, SC $55.47 $20.33 – $195.94 447,850 83
Columbia, MO $139.18 $22.36 – $542.23 446,955 229
Hammond, LA $74.12 $0.00 – $324.25 445,615 68
Alexandria, LA $70.53 $7.86 – $215.67 444,369 103
Cedar Rapids, IA $123.45 $16.03 – $2,044 441,777 104
Green Bay, WI $54.82 $17.35 – $182.56 440,979 92
Farmington, NM $158.46 $37.87 – $213.65 439,282 51
Fort Collins, CO $97.56 $39.65 – $213.65 437,891 109
Marietta, OH $109.57 $34.09 – $188.50 437,828 79
Fort Myers, FL $84.41 $0.00 – $412.93 434,735 210
Evansville, IN $110.87 $22.29 – $389.96 429,741 138
Anaheim, CA $82.43 $0.00 – $196.36 425,590 82
Laveen, AZ $221.20 $221.20 – $221.20 420,697 1
Stanford, CA $105.79 $0.00 – $397.20 411,677 260
Vallejo, CA $84.85 $0.00 – $966.31 409,509 77
San Juan, PR $66.54 $0.00 – $570.77 406,486 253
Hershey, PA $130.02 $29.43 – $2,226 405,079 122
Richland, WA $90.75 $0.00 – $136.91 401,634 60

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.