Average Medicaid Office Visit Payments in Hummelstown, PA: $52.19
Avg. Paid
$52.19
Range
$2.43 – $121.89
Total Claims
34,890
Providers
21
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 Hummelstown, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Timothy W Warren
300 E Main St |
$41.89 | 9,981 | 9,624 |
|
Cynthia Elsner
8105 Adams Dr Ste A |
$53.58 | 6,659 | 6,216 |
|
Natalie Swartzentruber
8105 Adams Dr Ste A |
$54.86 | 5,692 | 5,346 |
|
Deborah Julius
8105 Adams Dr |
$54.22 | 3,387 | 3,169 |
|
Sean Patrick Rhoads
605 E Main St |
$56.47 | 1,943 | 1,729 |
|
Naazneen Iqbal
8105 Adams Dr |
$56.10 | 1,866 | 1,793 |
|
Kimberly M Rarick
8105 Adams Dr Ste C |
$61.94 | 1,627 | 1,553 |
|
Richard T Cook
1540 Brookline Dr |
$60.68 | 1,270 | 1,242 |
|
Melissa Ann Meyer
8105 Adams Dr Ste C |
$46.28 | 735 | 696 |
|
Katherine Anne Zurbach
1135 Olde W Chocolate Ave Ste 101 |
$121.89 | 461 | 442 |
|
Joseph Franklin Thomas
655 Hershey Rd |
$47.46 | 245 | 235 |
|
Vagmin P Vora
1842 Gramercy Pl |
$63.10 | 238 | 230 |
|
Teresa L Such-Neibar
1135 Olde W Chocolate Ave Ste 101 |
$91.01 | 192 | 180 |
|
Marko Adam Miljkovic
1440 Deerfield Dr |
$2.43 | 173 | 124 |
|
Prajay Patel
29 W Main St |
$51.92 | 162 | 129 |
|
Shaessa L Wright
1135 Olde W Chocolate Ave Ste 101 |
$77.17 | 92 | 89 |
|
Alexandra G Swihura
1214 Research Blvd |
$35.58 | 65 | 63 |
|
Weibin Shi
1135 Olde W Chocolate Ave Ste 101 |
$48.77 | 51 | 51 |
|
John R Mantione
8105 Adams Dr |
$47.75 | 27 | 25 |
|
Pinnacle Health Medical Services
8105 Adams Dr |
$58.21 | 12 | 12 |
|
Natasha Lynn Romanoski
1135 Olde W Chocolate Ave |
$67.25 | 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 Hummelstown, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Hummelstown, PA is $52.19 per claim, based on 34,890 claims from 21 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 Hummelstown, PA?
There are 21 Medicaid providers offering Office Visit related services in Hummelstown, PA according to public payment data.
What is the price range for Office Visit in Hummelstown, PA?
Medicaid reimbursement for Office Visit in Hummelstown, PA ranges from $2.43 to $121.89 per claim, with an average of $52.19. 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
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Las Vegas, NV
Avg $54.47
8,578,324 claims · 3512 providers
Other Procedures in Hummelstown, PA
Physical Therapy
Avg $43.89
18,739 claims
Speech Therapy
Avg $12.64
11,323 claims
Eye Exam
Avg $21.86
6,965 claims
Emergency Room Visit
Avg $82.68
4,666 claims
Hearing Test (Audiometry)
Avg $0.89
1,528 claims
Blood Work & Lab Tests
Avg $9.95
1,296 claims
Urinalysis & Urine Tests
Avg $3.11
1,168 claims
Substance Abuse Treatment
Avg $1,012
981 claims