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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
Victorville, CA $66.45 $12.39 – $184.19 219,343 42
New Iberia, LA $82.43 $45.73 – $184.41 218,765 34
Oceanside, CA $90.58 $32.46 – $463.78 217,809 56
Manchester, NH $135.44 $15.03 – $196.88 216,951 71
West Islip, NY $117.74 $22.09 – $418.40 216,767 57
Brandon, FL $76.35 $2.86 – $247.33 216,226 95
Troy, NY $107.15 $24.44 – $125.11 216,033 28
Manhasset, NY $127.11 $16.86 – $508.05 215,967 144
Roswell, NM $140.98 $49.42 – $202.77 215,829 22
Cary, NC $136.17 $29.05 – $224.58 215,473 44
Midland, MI $116.89 $42.49 – $171.28 214,603 8
Lakeland, FL $65.84 $6.65 – $348.29 214,569 118
Sioux Falls, SD $92.67 $6.60 – $270.10 213,799 99
Danville, KY $91.06 $23.93 – $193.84 213,464 28
Boardman, OH $85.87 $34.27 – $268.39 213,380 56
Walnut Creek, CA $93.74 $0.00 – $382.44 211,109 106
Fishersville, VA $129.33 $31.63 – $266.26 209,468 36
Eureka, CA $89.61 $0.00 – $744.45 209,249 49
Santa Fe, NM $147.03 $26.72 – $310.31 208,977 51
Lubbock, TX $103.96 $0.00 – $678.13 208,669 126
Novi, MI $182.68 $119.05 – $213.21 208,279 3
London, KY $135.90 $42.99 – $189.86 207,778 23
Fort Smith, AR $70.90 $14.33 – $175.90 207,770 77
Hoboken, NJ $178.79 $28.30 – $304.05 207,302 43
Klamath Falls, OR $110.08 $47.83 – $186.02 207,040 38
Toms River, NJ $231.01 $28.71 – $379.15 206,206 59
Oregon, OH $86.97 $43.84 – $222.15 205,725 34
Racine, WI $55.72 $8.27 – $57.83 205,431 9
Traverse City, MI $98.06 $10.77 – $1,081 204,229 27
Kingsport, TN $105.62 $0.00 – $555.17 204,082 59
Poughkeepsie, NY $128.72 $3.49 – $311.31 204,049 62
Warren, MI $188.70 $32.16 – $219.29 203,746 23
Willimantic, CT $217.25 $2.40 – $324.11 203,542 18
Mcallen, TX $120.78 $0.00 – $1,492 203,406 84
Lawton, OK $161.04 $55.30 – $201.44 202,594 50
Hazard, KY $183.78 $32.66 – $349.99 201,972 28
Maitland, FL $68.70 $8.36 – $242.26 201,609 46
Davenport, IA $125.92 $8.21 – $1,143 201,327 51
Sioux City, IA $138.20 $0.00 – $2,275 200,767 58
La Crosse, WI $54.64 $17.06 – $216.66 200,060 103
Newark, OH $88.13 $26.12 – $176.82 199,270 47
Middletown, NY $124.41 $4.60 – $184.00 199,236 77
Longview, WA $91.97 $56.24 – $218.09 199,138 25
Silverdale, WA $94.64 $28.78 – $116.42 199,054 20
Mechanicsville, VA $125.31 $23.50 – $169.61 197,980 40
Federal Way, WA $84.90 $32.99 – $149.87 196,728 32
Murray, UT $53.79 $21.04 – $250.50 196,098 98
Woodbury, NJ $167.85 $21.47 – $329.38 195,989 33
Auburn, WA $86.16 $0.00 – $184.14 194,256 33
Laredo, TX $166.58 $0.00 – $425.85 194,210 49

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.