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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
Carmichael, CA $111.02 $7.23 – $189.78 244,288 39
Mission Hills, CA $67.92 $0.00 – $245.14 242,884 32
Stamford, CT $232.51 $19.14 – $334.24 241,827 57
Beachwood, OH $90.69 $4.54 – $120.06 241,687 45
Slidell, LA $93.45 $3.90 – $383.58 241,060 66
Westerville, OH $94.20 $19.84 – $188.66 239,848 52
Lakewood, CO $98.39 $0.00 – $195.22 238,723 100
Hopewell, VA $154.36 $27.05 – $165.59 238,190 16
Boise, ID $79.68 $30.64 – $770.85 237,704 142
Apple Valley, CA $67.13 $0.00 – $375.00 237,247 43
Minnetonka, MN $181.64 $58.27 – $242.95 236,111 76
Laurel, MS $110.27 $17.35 – $275.73 235,616 40
Santa Cruz, CA $85.44 $0.14 – $172.38 235,236 34
Missoula, MT $54.89 $2.55 – $325.70 233,927 40
Williamsburg, VA $107.16 $33.52 – $163.03 233,118 35
Orangeburg, SC $38.82 $23.90 – $144.14 232,756 29
Lawrence, MA $67.42 $4.71 – $178.38 232,655 46
Coral Gables, FL $100.21 $11.77 – $312.60 231,998 74
Winchester, VA $131.99 $12.89 – $304.15 231,446 69
Leesburg, VA $142.73 $39.54 – $206.58 231,157 37
Appleton, WI $51.76 $15.87 – $1,091 230,945 47
Fountain Valley, CA $66.13 $2.98 – $200.34 230,945 66
Waterloo, IA $132.61 $8.43 – $1,445 230,395 60
Longview, TX $158.89 $10.93 – $941.67 230,150 69
Mansfield, OH $89.29 $26.41 – $182.54 229,267 43
Downey, CA $278.23 $15.92 – $498.77 229,221 38
Ventura, CA $130.26 $0.00 – $1,187 227,642 58
Upland, CA $69.32 $5.76 – $133.41 227,225 24
Rockford, IL $69.98 $18.36 – $160.37 227,177 89
Goldsboro, NC $109.50 $3.49 – $230.80 226,739 51
Neptune, NJ $224.45 $33.10 – $306.46 225,797 32
Perth Amboy, NJ $198.04 $21.44 – $310.15 225,603 30
Lumberton, NC $99.51 $29.41 – $250.77 225,559 63
Kissimmee, FL $71.70 $1.14 – $203.22 225,016 97
Port Huron, MI $139.86 $31.39 – $185.46 224,870 11
Kailua, HI $184.58 $36.33 – $528.22 224,516 61
Anderson, IN $100.24 $10.19 – $195.69 224,378 51
Ukiah, CA $78.45 $0.00 – $780.83 223,446 43
Inglewood, CA $66.80 $32.88 – $111.45 223,302 40
North Bergen, NJ $207.49 $29.86 – $304.27 223,041 30
Turlock, CA $66.52 $0.00 – $135.66 222,793 32
Urbana, IL $68.84 $19.99 – $182.35 222,538 94
Somerset, KY $132.80 $36.19 – $183.05 221,462 26
Fairfield, OH $86.03 $34.98 – $141.99 221,349 42
Salisbury, MD $83.62 $27.77 – $158.84 220,822 47
Dover, DE $142.47 $0.00 – $441.69 220,056 60
Westlake, OH $83.49 $23.56 – $123.64 219,926 57
Santa Monica, CA $63.11 $10.99 – $226.50 219,456 74
Gastonia, NC $128.41 $33.03 – $298.98 219,453 56
Madison Heights, MI $135.11 $44.17 – $185.08 219,384 20

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.