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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
Martins Ferry, OH $86.61 $21.84 – $125.19 32,290 10
Waxahachie, TX $119.16 $26.70 – $258.71 32,209 18
Edmond, OK $135.42 $41.88 – $243.96 32,169 27
Tavares, FL $76.54 $59.17 – $98.84 32,151 8
Huntingdon, TN $80.49 $45.31 – $139.86 32,037 5
Frankfort, IN $101.46 $26.02 – $125.14 32,026 7
Douglas, AZ $275.45 $66.54 – $324.43 31,995 4
Manhattan, KS $65.11 $24.93 – $180.19 31,975 16
North Platte, NE $99.56 $43.96 – $263.04 31,975 13
Tylertown, MS $125.96 $24.19 – $158.59 31,960 7
San Ramon, CA $59.93 $0.00 – $110.69 31,938 16
Forest Grove, OR $130.07 $66.55 – $156.97 31,924 8
Gridley, CA $84.74 $10.30 – $96.20 31,904 4
Mount Dora, FL $71.46 $34.72 – $91.06 31,894 6
Winter Park, FL $62.27 $28.85 – $860.82 31,889 15
Kingwood, WV $166.69 $56.92 – $258.42 31,818 7
Lakewood, OH $90.96 $70.03 – $124.90 31,772 8
Carson City, NV $111.37 $55.34 – $142.57 31,735 16
Red Bluff, CA $168.81 $5.03 – $877.19 31,695 5
Sterling Heights, MI $66.69 $34.51 – $96.81 31,632 6
Greenfield, OH $98.35 $56.56 – $132.64 31,631 4
Kearney, NE $105.42 $47.32 – $174.69 31,622 14
Logansport, IN $80.42 $40.29 – $206.11 31,597 8
Iron River, MI $115.39 $24.79 – $116.17 31,524 2
Huntley, IL $70.28 $38.95 – $95.74 31,492 13
Zephyrhills, FL $70.57 $12.50 – $138.59 31,449 15
Barron, WI $125.88 $29.89 – $141.97 31,348 6
Shelbyville, TN $66.94 $0.00 – $155.70 31,308 6
Oviedo, FL $79.53 $32.27 – $334.11 31,265 16
Warren, PA $77.13 $4.50 – $102.96 31,251 13
Millinocket, ME $18.38 $18.38 – $18.38 31,210 1
Indianola, MS $112.44 $13.12 – $126.05 31,110 6
Saint Helena, CA $79.45 $0.00 – $176.79 31,101 16
Scottsboro, AL $45.50 $31.09 – $149.03 31,070 9
Hastings, NE $95.73 $52.73 – $125.03 31,013 11
Mayfield Heights, OH $76.02 $40.91 – $135.95 31,012 18
Pella, IA $119.46 $41.22 – $1,639 31,011 18
Twinsburg, OH $85.50 $66.56 – $184.48 31,011 6
Perrysburg, OH $77.78 $16.37 – $168.27 31,006 17
Florence, OR $218.91 $64.05 – $429.07 30,993 9
Reedsburg, WI $172.95 $30.48 – $192.07 30,988 3
Fallon, NV $79.97 $50.55 – $133.50 30,958 9
Clintwood, VA $159.39 $59.32 – $203.76 30,900 3
Onawa, IA $105.07 $48.58 – $186.54 30,871 4
Milford, OH $81.42 $34.01 – $86.10 30,837 4
Hyden, KY $243.00 $63.54 – $283.97 30,823 2
Safety Harbor, FL $83.65 $31.72 – $294.35 30,797 14
Somerset, NJ $68.00 $41.83 – $84.71 30,793 6
Seaford, DE $111.33 $12.49 – $166.97 30,776 9
Waycross, GA $73.42 $48.91 – $114.68 30,771 17

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.