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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
Youngstown, OH $89.51 $2.63 – $1,049 335,642 73
Johnson City, TN $90.83 $0.00 – $395.91 331,961 122
Wyoming, MI $103.44 $52.11 – $150.15 330,784 21
Belleville, NJ $261.83 $17.95 – $347.09 329,077 45
Lewiston, ME $131.85 $0.00 – $215.98 328,314 75
Pomona, NJ $377.21 $37.68 – $377.75 325,753 3
Livingston, NJ $244.83 $3.29 – $565.79 325,741 77
Grand Blanc, MI $122.49 $16.62 – $298.64 324,140 47
New London, CT $217.94 $17.94 – $358.26 323,425 62
Marrero, LA $103.90 $32.79 – $198.34 323,060 46
Murrieta, CA $175.13 $24.72 – $647.14 322,981 34
Springfield, OH $88.57 $36.66 – $122.71 320,863 41
Tupelo, MS $129.96 $23.74 – $188.01 316,420 51
Henderson, NV $97.98 $5.64 – $232.27 315,803 159
West Columbia, SC $56.90 $23.41 – $282.53 315,305 71
Portsmouth, OH $95.84 $22.35 – $236.53 313,734 52
Elizabeth, NJ $175.41 $15.01 – $274.36 311,968 50
Rome, GA $152.91 $24.66 – $423.55 310,576 64
Petersburg, VA $123.93 $49.07 – $163.38 309,262 30
Pomona, CA $72.32 $7.33 – $145.43 308,969 62
Stockton, CA $83.45 $0.00 – $339.98 308,656 82
Myrtle Beach, SC $79.55 $15.41 – $156.77 306,011 87
Pinehurst, NC $63.27 $0.00 – $162.85 305,300 47
Farmington, CT $133.76 $5.11 – $230.20 305,144 74
Iowa City, IA $119.10 $1.56 – $2,023 302,845 200
Wheeling, WV $121.67 $36.35 – $370.07 300,977 68
Gilbert, AZ $152.03 $1.63 – $235.76 300,376 72
Murfreesboro, TN $96.20 $14.99 – $498.30 300,286 82
Fort Thomas, KY $118.93 $39.96 – $280.87 299,995 44
Springfield, OR $148.13 $13.89 – $1,140 298,736 79
Daytona Beach, FL $79.65 $2.28 – $410.06 295,248 131
Roseville, CA $224.10 $0.19 – $427.46 292,690 82
Lowell, MA $141.93 $33.73 – $193.71 292,245 43
Rochester, MN $154.08 $15.00 – $1,104 291,969 228
Clarksville, TN $106.61 $7.45 – $409.15 291,469 60
Chesapeake, VA $107.18 $31.04 – $196.95 291,240 61
Woodbridge, VA $132.60 $25.77 – $179.87 291,139 31
Houma, LA $94.94 $24.71 – $281.78 290,477 64
Chula Vista, CA $153.18 $0.00 – $405.72 289,725 43
Mount Clemens, MI $150.30 $55.18 – $263.25 286,845 23
Edison, NJ $201.48 $28.00 – $286.46 285,731 43
Corbin, KY $122.18 $33.06 – $178.23 282,359 26
Carolina, PR $58.06 $0.00 – $180.81 282,272 85
Morristown, NJ $151.78 $16.70 – $292.63 282,140 101
Fontana, CA $191.26 $0.00 – $548.82 282,136 66
Reno, NV $82.82 $12.75 – $236.19 281,754 228
Asheville, NC $114.56 $22.97 – $659.98 281,558 149
Meriden, CT $218.70 $0.07 – $328.63 281,483 37
Danville, PA $91.85 $0.08 – $351.57 280,993 114
Garden City, MI $126.39 $13.71 – $184.83 280,840 39

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.