Skip to content
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
Wenatchee, WA $85.27 $29.63 – $162.68 279,046 48
Danville, VA $115.81 $33.61 – $143.45 278,362 24
Meridian, MS $112.70 $0.95 – $174.20 277,625 69
La Mesa, CA $187.08 $54.16 – $516.15 277,381 48
Bellingham, WA $78.41 $0.23 – $149.39 276,417 52
Rancho Mirage, CA $98.57 $56.22 – $413.33 276,235 79
Jackson, MI $149.03 $27.79 – $233.27 275,855 33
Fargo, ND $173.36 $29.37 – $494.88 275,570 90
Pennington, NJ $246.65 $28.38 – $380.36 274,846 45
Lincoln, NE $91.86 $41.81 – $203.02 274,786 79
Muncie, IN $121.04 $0.00 – $279.90 273,746 70
Topeka, KS $62.90 $23.14 – $416.98 272,908 94
Medford, OR $140.40 $0.00 – $506.55 272,519 103
Kansas City, KS $91.32 $20.18 – $387.06 272,121 146
Salem, VA $142.73 $44.40 – $174.78 271,220 37
Joplin, MO $137.40 $1.93 – $590.98 269,788 127
Danbury, CT $195.18 $11.89 – $313.03 268,934 60
Pasadena, CA $59.25 $7.97 – $106.63 268,520 76
Naperville, IL $61.44 $18.48 – $1,941 268,142 88
Tallahassee, FL $69.60 $4.54 – $191.40 267,878 116
Caguas, PR $47.91 $0.00 – $2,191 266,962 88
Prescott, AZ $180.08 $0.00 – $246.77 266,458 39
Everett, WA $87.70 $24.45 – $215.65 265,284 89
Zanesville, OH $90.01 $37.17 – $172.54 265,227 50
Ocala, FL $78.59 $2.45 – $235.43 264,757 120
Pembroke Pines, FL $63.95 $3.19 – $223.57 262,861 69
Shelby, NC $133.41 $31.57 – $181.52 262,166 45
Goodyear, AZ $163.57 $42.54 – $225.18 261,899 54
Janesville, WI $56.21 $9.96 – $114.43 261,364 55
Thornton, CO $101.39 $8.79 – $161.05 261,243 47
Elmhurst, NY $153.64 $24.39 – $199.90 259,838 65
New Bedford, MA $153.25 $0.00 – $400.25 259,680 50
Richmond, IN $98.35 $40.73 – $191.28 259,188 50
Hemet, CA $63.77 $37.81 – $204.39 259,128 22
Palm Springs, CA $145.06 $0.00 – $309.00 257,620 59
Fall River, MA $127.54 $34.33 – $195.42 256,274 78
Melbourne, FL $68.06 $7.59 – $765.62 255,533 118
Summit, NJ $189.96 $14.79 – $259.79 254,659 30
Middletown, CT $218.69 $9.44 – $276.59 254,571 40
Lynwood, CA $75.25 $24.51 – $158.83 252,079 41
Tuscaloosa, AL $45.22 $0.00 – $173.54 251,073 62
Beckley, WV $109.65 $0.00 – $503.77 250,956 36
Englewood, CO $95.08 $13.09 – $182.01 250,627 73
Columbus, MS $111.42 $19.56 – $140.75 250,035 27
Merced, CA $84.49 $16.75 – $131.71 249,697 31
Pascagoula, MS $107.94 $13.22 – $140.52 248,901 26
Chillicothe, OH $86.38 $41.28 – $159.22 247,843 46
Harrisburg, PA $86.13 $20.67 – $275.27 246,565 119
Sunrise, FL $76.42 $27.02 – $350.28 246,555 55
Bangor, ME $160.57 $14.72 – $307.76 245,511 72

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.