Average Medicaid Office Visit Payments in Middlesboro, KY: $32.95
Avg. Paid
$32.95
Range
$8.96 – $56.85
Total Claims
338,717
Providers
57
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 Middlesboro, KY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Radwa Clarissa Omar
3602 Cumberland Ave Ste B102 |
$29.50 | 36,371 | 23,966 |
|
Mohamad Hakam Alnahhas
3602 Cumberland Ave Ste B-102 |
$39.35 | 25,406 | 19,448 |
|
Larry B Roark
2317 Cumberland Ave |
$26.88 | 22,283 | 16,998 |
|
Crystal Lee Jones
100 College Rd Ste 131-132 |
$38.50 | 20,417 | 16,977 |
|
Ronald S Dubin
705 N 12Th Street |
$44.03 | 16,073 | 13,430 |
|
Carolyn Michelle Davis Rutherford
3602 Cumberland Ave Ste B102 |
$29.99 | 15,186 | 12,431 |
|
Katherine Marie Ebsworth-Mojica
2004 Cumberland Ave Ste 301 |
$49.61 | 13,980 | 12,040 |
|
Charles A Moore
123 N 19Th St |
$26.41 | 13,350 | 11,799 |
|
Karen Mcdaniel
3004 Cumberland Ave |
$25.38 | 13,214 | 10,732 |
|
Elizabeth S. Lucas
473 N 12Th St |
$43.70 | 12,669 | 10,367 |
|
Neil G Barry
3004 Cumberland Ave |
$36.10 | 11,663 | 9,584 |
|
Kristy Marie Smith
3503 Cumberland Ave |
$25.88 | 10,729 | 7,952 |
|
James Lee Williams
1530 Us Highway 25 E |
$38.65 | 10,470 | 8,967 |
|
James S Bazzi
3600 Cumberland Ave |
$31.47 | 8,967 | 7,839 |
|
Rebecca L Akers
2004 Cumberland Ave |
$30.10 | 8,945 | 6,717 |
|
Rachel Andrea Jones-Tackett
3602 Cumberland Ave Ste B102 |
$31.01 | 8,877 | 6,487 |
|
Maria A Hortillosa
3513 Cumberland Ave |
$27.72 | 7,731 | 6,127 |
|
Arh Mary Breckinridge Health Services, Inc.
3504 Cumberland Ave |
$12.19 | 6,704 | 4,972 |
|
Stephanie L Hutchison
2004 Cumberland Ave Ste 100 |
$40.62 | 6,163 | 4,891 |
|
Ashley N. Fultz
2010 Cumberland Ave |
$22.19 | 5,577 | 4,243 |
|
Thomas N Epperson
3004 Cumberland Ave |
$24.77 | 5,547 | 4,737 |
|
Nicole Pursifull
2145 Us Highway 25 E |
$27.98 | 4,774 | 4,213 |
|
Rogelio L. Uy
2032 Cumberland Ave |
$37.84 | 4,749 | 4,090 |
|
Rebecca Mynekia Hudson
125 W Lothbury Ave |
$30.70 | 4,710 | 4,120 |
|
Marcinia Michelle Bailey
123 N 19Th St |
$28.27 | 4,658 | 4,032 |
|
Blakelee Brock Barnett
2004 Cumberland Ave Ste 100 |
$30.64 | 4,516 | 3,299 |
|
Aimee Nicole Brock
123 N 19Th St |
$34.10 | 4,390 | 3,680 |
|
Charles I. Okwundu
2004 Cumberland Ave |
$34.42 | 3,495 | 2,839 |
|
Amber Denise Tolliver
3504 Cumberland Ave |
$35.08 | 2,767 | 2,315 |
|
Todd Marvin Mcgeorge
1431 Cumberland Ave |
$41.01 | 2,371 | 2,151 |
|
Lesha Loretta Ellison
2004 Cumberland Ave Ste 100 |
$32.19 | 2,237 | 1,330 |
|
Lovie A Stallworth
1217 Cumberland Ave |
$24.55 | 1,913 | 1,317 |
|
James L Taylor
2403 Cumberland Ave |
$25.75 | 1,741 | 1,337 |
|
Jason Stuart Taylor
311 North 12Th St |
$23.91 | 1,468 | 1,258 |
|
Pamela Cavins
3004 Cumberland Ave |
$38.59 | 1,421 | 1,125 |
|
Amber Craig Peace
3504 W Cumberland Ave |
$32.37 | 1,266 | 1,043 |
|
Patrick Earl Ball
1530 Us Highway 25 E |
$56.85 | 1,221 | 1,000 |
|
Middlesboro Health Department
111 N 21St St |
$33.71 | 1,181 | 1,087 |
|
Nitinkumar K Patel
3501 W Cumberland Ave |
$22.83 | 1,128 | 896 |
|
Tri State Medical Clinic Inc
3503 Cumberland Ave |
$18.99 | 1,032 | 829 |
|
Appalachian Regional Healthcare, Inc.
3600 Cumberland Ave |
$27.15 | 986 | 819 |
|
Robert Lee Thomas
123 N 19Th St |
$26.98 | 896 | 779 |
|
Tonya Michelle Turpin
2032 Cumberland Ave |
$38.50 | 884 | 776 |
|
Michael Anthony Lynch
3600 Cumberland Ave |
$46.90 | 766 | 641 |
|
Kentucky Friendly Care Center, Inc.
125 Lothbury Avenue |
$17.26 | 683 | 472 |
|
Emily Meister
1431 E Cumberland Ave |
$35.90 | 556 | 461 |
|
Richard D. Calhoun
3504 Cumberland Ave |
$41.03 | 463 | 385 |
|
Neil G Barry Iii Md Inc
3004 W Cumberland Avenue |
$19.94 | 462 | 430 |
|
Michelle A Garrett
1403 Cumberland Ave |
$22.50 | 437 | 366 |
|
Katie Ruth Simpson
235 New Wilson Ln |
$8.96 | 302 | 265 |
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 Middlesboro, KY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Middlesboro, KY is $32.95 per claim, based on 338,717 claims from 57 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 Middlesboro, KY?
There are 57 Medicaid providers offering Office Visit related services in Middlesboro, KY according to public payment data.
What is the price range for Office Visit in Middlesboro, KY?
Medicaid reimbursement for Office Visit in Middlesboro, KY ranges from $8.96 to $56.85 per claim, with an average of $32.95. 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 Middlesboro, KY
Blood Work & Lab Tests
Avg $15.04
379,317 claims
Durable Medical Equipment (DME)
Avg $38.88
91,051 claims
Emergency Room Visit
Avg $199.81
67,317 claims
Physical Therapy
Avg $27.15
65,158 claims
X-Ray
Avg $27.55
59,224 claims
Eye Exam
Avg $40.80
52,072 claims
Urinalysis & Urine Tests
Avg $10.67
48,348 claims
Chiropractic Care
Avg $15.23
38,912 claims