Average Medicaid Office Visit Payments in Everett, PA: $58.63
Avg. Paid
$58.63
Range
$11.77 – $82.52
Total Claims
41,258
Providers
23
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 Everett, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Ernesto M De Las Alas
10455 Lincoln Hwy |
$41.49 | 12 | 12 |
|
Jessica Suzanne Stone
33 E Main St |
$35.75 | 14 | 13 |
|
Tammie Payne
300 N Spring St |
$59.86 | 15 | 15 |
|
Jena Rae Stern
745 Raystown Rd |
$52.79 | 15 | 14 |
|
Jill Linton
195 Memorial Dr |
$52.63 | 42 | 41 |
|
Janelle Barkman
361 Hospital Dr |
$71.38 | 109 | 76 |
|
Brandon Jason Wilt
138 Memorial Dr |
$11.77 | 126 | 124 |
|
Dr Brandon J Wilt Dpm Llc
138 Memorial Dr |
$15.47 | 147 | 139 |
|
Horizon Behavioral Health, Pllc
16 Water St |
$75.73 | 156 | 72 |
|
Children'S Community Care
249 Hospital Dr Lowr Level |
$82.52 | 227 | 175 |
|
David Grant Baer
227 Hospital Dr |
$54.82 | 251 | 244 |
|
Lisa Duvall
227 Hospital Dr |
$53.05 | 256 | 251 |
|
Misty Spencer
10455 Lincoln Hwy |
$22.68 | 266 | 188 |
|
Stephen J Yanoshak
202 Memorial Dr |
$35.35 | 441 | 436 |
|
Flora Macalintal Torres
220 W Main St |
$56.87 | 447 | 441 |
|
Julia V Garcia
220 W Main St |
$51.64 | 553 | 540 |
|
George Michael Zubak
300 N Spring St |
$56.30 | 873 | 867 |
|
Sarah Hocker
283 Hospital Dr |
$48.44 | 1,990 | 1,958 |
|
Elliott Jody Bilofsky
202 Memorial Drive |
$38.20 | 2,788 | 2,723 |
|
Kimberlee A Hrabic
10455 Lincoln Hwy |
$65.91 | 3,197 | 3,128 |
|
Brian Guy Dowling
138 Memorial Dr |
$57.45 | 3,383 | 2,820 |
|
Draion Burch
361 Hospital Dr |
$55.69 | 9,764 | 8,005 |
|
Amy J Mullen
185 Hospital Dr |
$66.01 | 16,186 | 14,804 |
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 Everett, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Everett, PA is $58.63 per claim, based on 41,258 claims from 23 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 Everett, PA?
There are 23 Medicaid providers offering Office Visit related services in Everett, PA according to public payment data.
What is the price range for Office Visit in Everett, PA?
Medicaid reimbursement for Office Visit in Everett, PA ranges from $11.77 to $82.52 per claim, with an average of $58.63. 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
13,626,712 claims · 3705 providers
Phoenix, AZ
Avg $47.53
13,269,420 claims · 4233 providers
Houston, TX
Avg $48.27
8,766,644 claims · 4540 providers
Las Vegas, NV
Avg $54.47
8,578,324 claims · 3512 providers
Other Procedures in Everett, PA
Emergency Room Visit
Avg $90.30
13,845 claims
Blood Work & Lab Tests
Avg $6.14
9,158 claims
Hearing Test (Audiometry)
Avg $2.50
4,547 claims
Podiatry (Foot Care)
Avg $11.14
4,459 claims
Physical Therapy
Avg $14.88
3,582 claims
Psychiatric Evaluation
Avg $81.03
3,471 claims
Eye Exam
Avg $24.39
2,601 claims
Urinalysis & Urine Tests
Avg $4.19
2,543 claims