Average Medicaid Office Visit Payments in Clarks Summit, PA: $43.44
Avg. Paid
$43.44
Range
$0.00 – $85.66
Total Claims
9,192
Providers
11
Typical Payment Range
Typical Medicaid Office Visit payments fall between $29.28 and $67.92 per claim (median: $46.55). The top 10% of payments exceed $95.29.
Based on per-provider averages across all Medicaid claims in this category.
A standard doctor's office visit for evaluation and management of medical conditions. Includes new patient visits, follow-up visits, and consultations.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Office Visit in Clarks Summit, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Anders P. Nelson
110 Layton Rd |
$38.34 | 4,007 | 3,491 |
|
Louis M Kareha
790 Northern Blvd |
$36.51 | 2,453 | 2,192 |
|
Joanne L Tanner
101 N State St |
$85.66 | 1,094 | 1,088 |
|
Jeffrey Michael Montgomery
407 N State St |
$38.53 | 662 | 618 |
|
Haitham Abughnia
401 N State St |
$42.52 | 632 | 610 |
|
Samir Bipin Pancholy
401 N State St |
$40.64 | 122 | 118 |
|
Mary Jennifer Frattali
503 S State St |
$20.08 | 84 | 81 |
|
Anders P. Nelson, Md, Pc
110 Layton Road |
$32.84 | 74 | 50 |
|
Michael H Gordon
407 N State St |
$26.22 | 34 | 28 |
|
Melissa Scalera
790 Northern Blvd |
$0.00 | 18 | 12 |
|
Sheela S Prahalad
319 N State St |
$0.00 | 12 | 12 |
What to Expect: Office Visit
A typical office visit lasts 15-45 minutes depending on complexity. Your doctor will review your medical history, discuss symptoms, perform a physical exam, and discuss treatment options. You may receive prescriptions, referrals, or orders for diagnostic tests. Follow-up visits are usually shorter than new patient visits.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 99213 | Office visit established mod | $43.18 | 764,306,590 | 487,602 |
| 99214 | Office visit established mod-hi | $59.53 | 502,480,931 | 466,856 |
| 99212 | Office visit established low | $41.69 | 92,299,154 | 127,462 |
| 99203 | Office visit new moderate | $67.55 | 47,756,882 | 127,334 |
| 99211 | Office visit established minor | $39.24 | 44,127,221 | 47,748 |
| 99204 | Office visit new moderate-high | $92.03 | 32,379,031 | 111,937 |
| 99215 | Office visit established high | $93.58 | 29,619,773 | 74,725 |
| 99202 | Office visit new low | $58.57 | 9,372,712 | 35,486 |
| 99205 | Office visit new high | $136.10 | 3,665,382 | 19,737 |
| 99244 | Office consultation mod-high | $118.25 | 3,405,681 | 11,884 |
| 99243 | Office consultation moderate | $78.55 | 2,585,480 | 8,432 |
| 99245 | Office consultation high | $132.29 | 645,300 | 3,046 |
| 99242 | Office consultation low | $58.27 | 483,445 | 1,980 |
| 99241 | Office consultation brief | $66.15 | 295,664 | 712 |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Office Visit cost in Clarks Summit, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Clarks Summit, PA is $43.44 per claim, based on 9,192 claims from 11 providers. Typical payments fall between $29.28 and $67.92. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Office Visit in Clarks Summit, PA?
There are 11 Medicaid providers offering Office Visit related services in Clarks Summit, PA according to public payment data.
What is the price range for Office Visit in Clarks Summit, PA?
Medicaid reimbursement for Office Visit in Clarks Summit, PA ranges from $0.00 to $85.66 per claim, with an average of $43.44. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Office Visit in Other Cities
Brooklyn, NY
Avg $71.20
32,336,840 claims · 5588 providers
New York, NY
Avg $81.86
23,551,154 claims · 7530 providers
Los Angeles, CA
Avg $24.20
16,948,065 claims · 5565 providers
Chicago, IL
Avg $30.31
13,989,780 claims · 5801 providers
Bronx, NY
Avg $82.40
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Phoenix, AZ
Avg $47.53
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Houston, TX
Avg $48.27
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Las Vegas, NV
Avg $54.47
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Other Procedures in Clarks Summit, PA
Home Health Visit
Avg $204.63
110,625 claims
Dental Cleaning & Exam
Avg $34.48
5,518 claims
Physical Therapy
Avg $45.05
4,060 claims
Eye Exam
Avg $15.07
3,717 claims
Ultrasound
Avg $38.73
2,793 claims
CT Scan (Computed Tomography)
Avg $37.61
1,658 claims
MRI (Magnetic Resonance Imaging)
Avg $126.32
1,634 claims
X-Ray
Avg $6.00
1,554 claims