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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
Grafton, WV $99.24 $50.91 – $161.28 29,381 9
Bedford, OH $81.14 $0.96 – $116.87 29,321 9
Crossville, TN $92.29 $53.33 – $158.43 29,238 11
Hornell, NY $124.61 $48.53 – $154.28 29,238 5
Meadowbrook, PA $145.14 $0.00 – $297.57 29,132 16
Mustang, OK $137.10 $81.64 – $166.41 29,126 4
Phenix City, AL $71.23 $39.93 – $127.83 29,119 7
Marlborough, MA $183.94 $22.27 – $199.24 29,030 7
Franklin, NH $245.22 $29.62 – $256.38 28,965 4
Sandusky, MI $127.76 $127.76 – $127.76 28,924 1
Pittsfield, IL $68.78 $36.74 – $118.90 28,904 9
El Dorado Springs, MO $133.06 $102.49 – $137.71 28,816 4
Iuka, MS $99.96 $4.68 – $130.01 28,598 6
Paradise, CA $68.87 $7.70 – $74.00 28,531 6
Hilliard, OH $91.91 $29.38 – $164.57 28,522 15
Andalusia, AL $45.15 $35.23 – $93.31 28,500 9
Monroe, WI $50.82 $24.02 – $67.47 28,482 15
Rockwall, TX $115.31 $24.76 – $278.39 28,480 19
Bellevue, NE $111.71 $44.23 – $170.93 28,471 12
Tahlequah, OK $164.24 $9.95 – $185.55 28,421 11
Jacksonville, AR $58.18 $24.63 – $91.98 28,376 9
Bryn Mawr, PA $121.07 $21.16 – $305.38 28,258 29
Exeter, NH $134.40 $14.06 – $318.94 28,182 11
Dennison, OH $93.71 $41.62 – $114.63 28,168 5
Eupora, MS $117.92 $24.17 – $137.25 28,164 7
Spring Valley, OH $89.16 $89.16 – $89.16 28,148 1
Cheverly, MD $91.46 $47.92 – $203.57 28,145 16
Rifle, CO $110.55 $38.25 – $142.15 28,135 13
Potosi, MO $116.93 $61.08 – $139.14 28,087 7
Centreville, MS $97.48 $30.08 – $99.92 28,035 4
Athens, TX $138.48 $41.51 – $189.16 28,009 9
Hutchinson, KS $61.43 $25.99 – $198.53 28,000 13
Rhinebeck, NY $158.26 $55.26 – $166.35 27,964 6
Ogallala, NE $98.21 $92.58 – $169.23 27,942 4
Salem, IN $91.54 $86.62 – $110.51 27,941 4
Jerseyville, IL $60.09 $42.74 – $71.26 27,939 4
Hoffman Estates, IL $64.67 $35.87 – $87.01 27,922 8
Mt Airy, NC $76.49 $68.48 – $87.29 27,884 4
Ladysmith, WI $130.40 $25.04 – $151.31 27,863 9
Southampton, NY $146.30 $0.00 – $195.19 27,846 13
Everett, MA $70.51 $34.77 – $143.75 27,788 10
Camden, TN $113.00 $37.73 – $120.19 27,701 5
Forest, MS $175.01 $7.40 – $179.35 27,654 4
Sandy, UT $40.36 $25.39 – $98.03 27,597 13
Stillwater, OK $144.80 $39.26 – $184.14 27,516 10
Charlevoix, MI $151.88 $71.14 – $209.53 27,498 3
Haymarket, VA $241.55 $241.55 – $241.55 27,433 1
St Augustine, FL $69.18 $13.85 – $172.51 27,385 16
Pace, FL $59.38 $26.88 – $111.25 27,384 8
Inverness, FL $68.32 $2.66 – $162.64 27,375 21

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.