Objective: The paper analyzed the impact of the medical service price reform in public hospitals above the county level in Shaoxing City on the average expenses of outpatient and emergency department under the background of medical insurance management at municipal level. Methods: The degree of structural variation and gray correlation method were used to analyze the structural change and the correlation degree of the outpatient and emergency expenses in public hospitals before and after the implementation of the reform. Results: Before and after the reform, the expenses of vaccine, Chinese patent medicine, examination, surgery, diagnosis, and treatment showed a positive trend, while the expenses of laboratory testing, Chinese herb pieces, western medicine, medical materials and the other expenses showed a negative trend. Western medicine expenses were the main factor influencing the average cost, followed by the diagnosis, the treatment and so on. Conclusions: The reform had generally realized the unification of medical service prices at municipal level, and didn't significantly increase the burden of patients. The labor of medical personnel was valued, therefore the preliminary progress had been achieved. However, structural adjustment of the examination expenses needs to be further strengthened in the future.