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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
Canton, IL $46.48 $35.33 – $58.81 22,689 5
Alamosa, CO $108.55 $31.94 – $162.58 22,685 8
Livingston, MT $27.43 $13.49 – $156.98 22,654 6
Coal Valley, IL $125.02 $125.02 – $125.02 22,652 1
Lewisburg, WV $145.73 $71.18 – $178.06 22,650 5
Windsor, NC $106.05 $52.32 – $122.97 22,625 6
Sherman, TX $74.86 $30.51 – $184.74 22,620 21
Thomasville, AL $46.44 $0.00 – $53.91 22,601 5
Ocean Springs, MS $69.47 $44.17 – $92.55 22,595 13
Glen Cove, NY $167.19 $31.27 – $185.03 22,589 8
Rainbow City, AL $108.82 $56.64 – $130.81 22,565 2
Bluffton, SC $61.30 $22.16 – $68.60 22,540 6
Dadeville, AL $33.97 $0.00 – $43.35 22,506 6
Tamuning, GU $94.56 $35.82 – $220.26 22,479 7
Pahrump, NV $95.17 $8.37 – $129.51 22,476 12
Camp Pendleton, CA $71.06 $44.36 – $138.82 22,471 11
Buckeye, WV $133.54 $63.29 – $170.21 22,465 10
Iowa Falls, IA $110.26 $104.41 – $218.21 22,460 5
Liberty, KY $150.96 $18.83 – $167.85 22,445 4
Fort Belvoir, VA $90.13 $27.38 – $131.64 22,442 12
Hudson, WI $137.73 $12.58 – $203.76 22,434 10
Venice, FL $81.16 $9.12 – $192.42 22,433 16
Wolf Point, MT $14.03 $5.54 – $51.81 22,417 2
Woodworth, LA $44.83 $44.81 – $75.06 22,372 2
Elko, NV $89.75 $61.54 – $99.62 22,323 9
Great Barrington, MA $358.90 $57.34 – $431.44 22,323 7
Ashland, OR $186.46 $35.76 – $430.05 22,295 12
Malone, NY $129.02 $31.01 – $181.29 22,289 7
Alexandria, MN $207.57 $32.33 – $235.42 22,265 10
Pittsburg, KS $46.23 $22.72 – $74.44 22,245 13
Upland, PA $136.55 $28.68 – $235.34 22,243 10
Burnsville, MN $150.52 $68.00 – $244.63 22,242 13
Barnesville, OH $85.69 $62.17 – $122.27 22,220 4
Cleveland Heights, OH $68.38 $3.64 – $73.72 22,200 3
Lackland Afb, TX $106.07 $22.86 – $132.48 22,188 6
Pagosa Springs, CO $105.46 $38.19 – $183.24 22,168 14
Las Piedras, PR $51.99 $5.89 – $88.80 22,142 10
Canal Winchester, OH $127.60 $74.55 – $139.09 22,137 2
Travelers Rest, SC $25.51 $16.77 – $46.79 22,100 3
Richmond, TX $148.23 $39.36 – $337.58 22,091 20
Owatonna, MN $189.76 $173.71 – $266.53 22,055 7
Garland, TX $116.56 $36.90 – $322.50 22,034 15
Del Mar, CA $95.81 $56.06 – $110.98 22,030 4
Spartangburg, SC $105.88 $105.88 – $105.88 22,021 1
Pineville, LA $68.28 $38.19 – $203.79 22,007 10
Paragould, AR $58.04 $4.00 – $93.45 21,980 12
Bartow, FL $56.80 $28.38 – $82.26 21,951 10
Gray, TN $115.98 $115.98 – $115.98 21,936 1
Yuba City, CA $85.08 $0.00 – $847.29 21,915 13
Paoli, PA $117.01 $0.00 – $307.57 21,913 16

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.