Average Medicaid Office Visit Payments in Lexington, TN: $41.42
Avg. Paid
$41.42
Range
$9.91 – $78.58
Total Claims
189,189
Providers
48
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, TN
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Ashley M Shuler
107 Lexington Plz |
$32.91 | 12 | 12 |
|
David Barton Waters
250 Boswell St |
$26.34 | 14 | 13 |
|
Deborah Hopper
864 W Church St |
$24.82 | 35 | 30 |
|
Michael Lee Patterson
107 Lexington Plz |
$9.91 | 35 | 29 |
|
James Burrow
9550 Highway 412 W |
$35.61 | 92 | 84 |
|
Christopher Hall Bratton
250 Boswell St |
$26.21 | 147 | 121 |
|
Eric R Telfer
200 W Church St |
$33.79 | 230 | 220 |
|
Leah Beth Gilliam
83 S Main St |
$18.42 | 433 | 352 |
|
Lexington Hospital Corporation
270 W Church St Ste A |
$48.63 | 678 | 577 |
|
Sara Palomino
1560 N Broad St |
$34.76 | 720 | 615 |
|
Dennis Paul Orr
200 W Church St |
$78.58 | 762 | 589 |
|
Hillary Blankenship
1560 N Broad St |
$34.98 | 788 | 674 |
|
Sarah Elizabeth Bridges
270 W Church St |
$29.11 | 807 | 679 |
|
Charleston Bailee Wallace
157 W Church St |
$28.70 | 977 | 665 |
|
Cathy Elizabeth Dorris
1560 N Broad St |
$32.81 | 1,059 | 809 |
|
Jessica Stanfill
270 W Church St Ste A |
$27.15 | 1,344 | 1,092 |
|
Patricia A Kirk
9486 Highway 412 W |
$13.47 | 1,362 | 1,049 |
|
Pamela Clover Brunson
16570 Highway 104 N |
$31.35 | 1,453 | 1,193 |
|
Hannah Lee Shelby-Kennedy
200 W Church St |
$39.31 | 1,680 | 1,491 |
|
Teresa Lynn Cox
125 W Church St |
$42.24 | 1,688 | 1,412 |
|
Brandy Bartholomew
157 W Church St |
$39.66 | 2,167 | 1,861 |
|
Tara Hendrix
9550 Hwy 412W Suite C |
$28.54 | 2,234 | 1,811 |
|
Elizabeth Ann Snider
10777 Highway 412 W |
$46.03 | 2,403 | 2,192 |
|
Thomas C Mcdonald
200 W Church St |
$19.90 | 2,438 | 1,909 |
|
Casey Beecham Blair
10777 Highway 412 W |
$42.59 | 2,799 | 2,613 |
|
Megan Rea Pittman
125 W Church St |
$50.95 | 2,892 | 2,492 |
|
Alan Davis Weatherford
200 W Church St |
$30.13 | 3,096 | 2,543 |
|
Robert G Day
9550 Highway 412 W Ste C |
$27.15 | 3,654 | 2,849 |
|
Alicia Gaile Springer
16615 Highway 104 N |
$27.70 | 3,945 | 2,894 |
|
Leslie Lee
844 Natchez Trace Dr |
$44.81 | 4,447 | 3,783 |
|
Megan Lynn Essary
Goodwin Children'S Clinic |
$45.14 | 4,492 | 3,943 |
|
Natasha Mae Loftin
200 W Church St |
$27.61 | 5,126 | 4,107 |
|
Robert J. Pomphrey
16615 Highway 104 N Ste B |
$41.82 | 5,355 | 4,439 |
|
Melinda S Maranto
727 E Church St |
$37.02 | 5,927 | 5,088 |
|
Deborah Dickinson
125 W Church St |
$50.24 | 6,067 | 5,438 |
|
Mary Katheryn Jones Goodwin
157 W Church St |
$48.82 | 6,291 | 5,381 |
|
Kary Mcpherson Morford
844 Natchez Trace Dr N |
$43.51 | 6,383 | 5,361 |
|
Chenoa Archer
125 W Church St |
$49.92 | 6,507 | 5,646 |
|
Crystal Gail Mcdaniel
250 Boswell Street |
$45.33 | 7,008 | 6,530 |
|
Ashley Kate Melton
10777 Highway 412 W |
$44.26 | 7,799 | 7,258 |
|
Rachel Tyler Walker
157 W Church St |
$43.87 | 7,919 | 6,891 |
|
Stephanie Everett
125 W Church St |
$51.07 | 8,588 | 7,001 |
|
Kendra D Grissom
10777 Highway 412 W |
$46.21 | 8,905 | 7,889 |
|
Reggie Allan Henderson
200 W Church St |
$36.70 | 9,255 | 7,732 |
|
Tammy Colwick Milholen
270 W Church St |
$30.43 | 9,984 | 7,892 |
|
Chad C Scott
200 W Church St |
$34.39 | 10,537 | 8,875 |
|
Julie Dianne Cantrell
270 W Church St |
$53.00 | 13,385 | 11,296 |
|
Jonathan D Lentz
10777 Highway 412 W |
$45.08 | 15,270 | 13,898 |
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, TN?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Lexington, TN is $41.42 per claim, based on 189,189 claims from 48 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, TN?
There are 48 Medicaid providers offering Office Visit related services in Lexington, TN according to public payment data.
What is the price range for Office Visit in Lexington, TN?
Medicaid reimbursement for Office Visit in Lexington, TN ranges from $9.91 to $78.58 per claim, with an average of $41.42. 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, TN
Emergency Room Visit
Avg $78.42
125,842 claims
Blood Work & Lab Tests
Avg $3.81
70,126 claims
Dental Cleaning & Exam
Avg $27.44
50,545 claims
Vaccines & Immunizations
Avg $17.46
40,269 claims
Ambulance Transport
Avg $51.05
39,637 claims
Physical Therapy
Avg $34.89
34,234 claims
Eye Exam
Avg $36.98
24,517 claims
Urinalysis & Urine Tests
Avg $1.42
16,961 claims