Average Medicaid Office Visit Payments in Lexington, SC: $71.88
Avg. Paid
$71.88
Range
$4.06 – $338.01
Total Claims
565,550
Providers
184
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 Lexington, SC
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Richard Kyle Guyton
424 Old Cherokee Rd |
$78.83 | 34,515 | 32,336 |
|
James Luther Pruitt
448 Old Cherokee Rd |
$81.52 | 33,787 | 30,391 |
|
South Carolina Dept Of Mental Health Accounting Office
301 Palmetto Park Blvd |
$164.71 | 25,096 | 23,178 |
|
Megan S Boltin
1223 S Lake Dr Ste G |
$76.84 | 24,209 | 22,339 |
|
Andrew Pittard
448 Old Cherokee Rd |
$78.32 | 21,470 | 19,646 |
|
Sonya Hatfield Head
1970 Augusta Hwy |
$78.44 | 17,067 | 15,449 |
|
Lachin Hatemi
247 Columbia Ave |
$65.08 | 15,542 | 13,513 |
|
Joseph Allen Delaney
424 Old Cherokee Rd |
$75.90 | 14,599 | 13,857 |
|
Naren S. Shenoy
1970 Augusta Hwy |
$75.33 | 12,663 | 11,390 |
|
James Brandon Emery
811 W Main St |
$74.55 | 11,952 | 11,011 |
|
James Baker Dewar
1970 Augusta Hwy |
$77.89 | 11,471 | 10,457 |
|
Lauren Shull Matthews
811 W Main St |
$73.39 | 11,212 | 10,462 |
|
Bruce K Cope
4568 Sunset Blvd |
$78.39 | 10,850 | 9,942 |
|
Amanda Ruscin Vartanian
811 W Main St Ste 204 |
$74.19 | 9,749 | 8,798 |
|
State Of South Carolina
1070-B South Lake Drive |
$55.66 | 9,715 | 9,508 |
|
Linda M Mestler
811 W Main St |
$57.83 | 9,707 | 8,756 |
|
Caleb E. Wheeler
811 W Main St |
$74.37 | 9,378 | 8,646 |
|
Ashley Carter
424 Old Cherokee Rd |
$68.92 | 8,880 | 7,987 |
|
James R Shennan
811 W Main St |
$63.48 | 8,873 | 8,676 |
|
Jeffrey A Lohr
811 W Main St |
$64.22 | 8,744 | 8,565 |
|
Caroline Burnett Webber
811 W Main St Ste 204 |
$69.92 | 8,479 | 7,806 |
|
Clifford D Staggs
811 W Main St |
$61.96 | 8,265 | 8,096 |
|
Christie P Thomas
4568 Sunset Blvd |
$75.31 | 8,118 | 7,546 |
|
Leah Lane Shutt Smith
4568 Sunset Blvd |
$75.95 | 7,917 | 7,407 |
|
Teonica Murphy
811 W Main St |
$50.15 | 7,119 | 6,960 |
|
Kristen Chicola Neil
424 Old Cherokee Rd |
$79.22 | 7,083 | 6,635 |
|
Gordon H Bobbett
154 Saluda Pointe Court |
$62.39 | 6,459 | 6,304 |
|
Helen D Latham
5336 Sunset Blvd Ste A |
$63.48 | 6,022 | 5,431 |
|
Celeste M Nelson
811 W Main St |
$42.12 | 5,683 | 5,529 |
|
Lillie Edwards Bates
811 W Main St |
$65.93 | 5,322 | 4,825 |
|
Thomas E Gibbons
811 W Main St |
$71.72 | 5,217 | 5,058 |
|
Virginia L Mcclain
247 Columbia Ave |
$76.94 | 4,641 | 4,344 |
|
Amber Timmons
811 W Main St |
$52.19 | 4,532 | 4,467 |
|
Mickey F Plymale
104 Saluda Pointe Dr |
$54.52 | 4,283 | 4,119 |
|
William T Korman
122 Powell Dr |
$52.24 | 4,151 | 3,341 |
|
Andrea Alicia Alexander
5336 Sunset Blvd Ste A |
$46.01 | 3,826 | 3,138 |
|
Cheryl Bradley Gambrell
4568 Sunset Blvd |
$74.04 | 3,786 | 3,641 |
|
Mark S Green
1847 S Lake Dr |
$53.23 | 3,768 | 3,478 |
|
Kevin Q Shalkham
5535 Platt Springs Rd |
$45.62 | 3,496 | 2,649 |
|
Payam Yousefian
5224 Sunset Blvd |
$71.05 | 3,484 | 3,255 |
|
Kelli Marie Hudon
5535 Platt Springs Rd |
$53.11 | 3,443 | 2,882 |
|
Henry Evan Dingle
154 Saluda Pointe Dr |
$64.17 | 3,383 | 3,300 |
|
Lauren Tober Monk
4568 Sunset Blvd |
$76.98 | 3,381 | 3,301 |
|
Michael P Taillon
811 W Main St |
$68.83 | 3,266 | 3,187 |
|
Valerie Bradley Dantzler
157 Corley Mill Rd |
$49.87 | 3,219 | 3,072 |
|
Whitney M Dellinger
2351 Augusta Hwy |
$48.87 | 3,205 | 3,148 |
|
Andrea Shipp Garrick
811 W Main St Ste 201&209 |
$63.15 | 3,156 | 2,760 |
|
Wendy Leigh Miller
605 W Main St |
$62.40 | 3,079 | 2,991 |
|
Thomas D Bryan
5535 Platt Springs Rd |
$54.10 | 2,959 | 2,297 |
|
John L Saunders
815 Highway 378 |
$79.97 | 2,930 | 2,835 |
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 Lexington, SC?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Lexington, SC is $71.88 per claim, based on 565,550 claims from 184 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 Lexington, SC?
There are 184 Medicaid providers offering Office Visit related services in Lexington, SC according to public payment data.
What is the price range for Office Visit in Lexington, SC?
Medicaid reimbursement for Office Visit in Lexington, SC ranges from $4.06 to $338.01 per claim, with an average of $71.88. 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 Lexington, SC
Home Health Visit
Avg $71.51
466,969 claims
Personal Care Services
Avg $27.09
224,532 claims
Vaccines & Immunizations
Avg $18.26
216,231 claims
Speech Therapy
Avg $58.70
213,419 claims
Dental Cleaning & Exam
Avg $33.23
202,701 claims
Psychiatric Evaluation
Avg $139.71
186,171 claims
Ambulance Transport
Avg $48.43
167,981 claims
Physical Therapy
Avg $70.19
131,680 claims