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 |
|---|---|---|---|
|
Lloyd Lee Cain
2145 Us Highway 25 E |
$23.91 | 13 | 12 |
|
Charles A Crumley
3004 Cumberland Ave |
$22.77 | 41 | 38 |
|
Brooke Villanueva Laughter
3600 Cumberland Ave |
$38.37 | 49 | 40 |
|
Nagaishwarya Moka
3602 Cumberland Ave |
$24.35 | 65 | 54 |
|
Holly Renee Booth
1502 Cumberland Ave |
$54.71 | 226 | 212 |
|
Arh Mary Breckinridge Health Services, Inc.
2032 Cumberland Ave |
$30.20 | 233 | 191 |
|
Meredith Masoner
2004 Cumberland Ave |
$26.43 | 295 | 208 |
|
Katie Ruth Simpson
235 New Wilson Ln |
$8.96 | 302 | 265 |
|
Michelle A Garrett
1403 Cumberland Ave |
$22.50 | 437 | 366 |
|
Neil G Barry Iii Md Inc
3004 W Cumberland Avenue |
$19.94 | 462 | 430 |
|
Richard D. Calhoun
3504 Cumberland Ave |
$41.03 | 463 | 385 |
|
Emily Meister
1431 E Cumberland Ave |
$35.90 | 556 | 461 |
|
Kentucky Friendly Care Center, Inc.
125 Lothbury Avenue |
$17.26 | 683 | 472 |
|
Michael Anthony Lynch
3600 Cumberland Ave |
$46.90 | 766 | 641 |
|
Tonya Michelle Turpin
2032 Cumberland Ave |
$38.50 | 884 | 776 |
|
Robert Lee Thomas
123 N 19Th St |
$26.98 | 896 | 779 |
|
Appalachian Regional Healthcare, Inc.
3600 Cumberland Ave |
$27.15 | 986 | 819 |
|
Tri State Medical Clinic Inc
3503 Cumberland Ave |
$18.99 | 1,032 | 829 |
|
Nitinkumar K Patel
3501 W Cumberland Ave |
$22.83 | 1,128 | 896 |
|
Middlesboro Health Department
111 N 21St St |
$33.71 | 1,181 | 1,087 |
|
Patrick Earl Ball
1530 Us Highway 25 E |
$56.85 | 1,221 | 1,000 |
|
Amber Craig Peace
3504 W Cumberland Ave |
$32.37 | 1,266 | 1,043 |
|
Pamela Cavins
3004 Cumberland Ave |
$38.59 | 1,421 | 1,125 |
|
Jason Stuart Taylor
311 North 12Th St |
$23.91 | 1,468 | 1,258 |
|
James L Taylor
2403 Cumberland Ave |
$25.75 | 1,741 | 1,337 |
|
Lovie A Stallworth
1217 Cumberland Ave |
$24.55 | 1,913 | 1,317 |
|
Lesha Loretta Ellison
2004 Cumberland Ave Ste 100 |
$32.19 | 2,237 | 1,330 |
|
Todd Marvin Mcgeorge
1431 Cumberland Ave |
$41.01 | 2,371 | 2,151 |
|
Amber Denise Tolliver
3504 Cumberland Ave |
$35.08 | 2,767 | 2,315 |
|
Charles I. Okwundu
2004 Cumberland Ave |
$34.42 | 3,495 | 2,839 |
|
Aimee Nicole Brock
123 N 19Th St |
$34.10 | 4,390 | 3,680 |
|
Blakelee Brock Barnett
2004 Cumberland Ave Ste 100 |
$30.64 | 4,516 | 3,299 |
|
Marcinia Michelle Bailey
123 N 19Th St |
$28.27 | 4,658 | 4,032 |
|
Rebecca Mynekia Hudson
125 W Lothbury Ave |
$30.70 | 4,710 | 4,120 |
|
Rogelio L. Uy
2032 Cumberland Ave |
$37.84 | 4,749 | 4,090 |
|
Nicole Pursifull
2145 Us Highway 25 E |
$27.98 | 4,774 | 4,213 |
|
Thomas N Epperson
3004 Cumberland Ave |
$24.77 | 5,547 | 4,737 |
|
Ashley N. Fultz
2010 Cumberland Ave |
$22.19 | 5,577 | 4,243 |
|
Stephanie L Hutchison
2004 Cumberland Ave Ste 100 |
$40.62 | 6,163 | 4,891 |
|
Arh Mary Breckinridge Health Services, Inc.
3504 Cumberland Ave |
$12.19 | 6,704 | 4,972 |
|
Maria A Hortillosa
3513 Cumberland Ave |
$27.72 | 7,731 | 6,127 |
|
Rachel Andrea Jones-Tackett
3602 Cumberland Ave Ste B102 |
$31.01 | 8,877 | 6,487 |
|
Rebecca L Akers
2004 Cumberland Ave |
$30.10 | 8,945 | 6,717 |
|
James S Bazzi
3600 Cumberland Ave |
$31.47 | 8,967 | 7,839 |
|
James Lee Williams
1530 Us Highway 25 E |
$38.65 | 10,470 | 8,967 |
|
Kristy Marie Smith
3503 Cumberland Ave |
$25.88 | 10,729 | 7,952 |
|
Neil G Barry
3004 Cumberland Ave |
$36.10 | 11,663 | 9,584 |
|
Elizabeth S. Lucas
473 N 12Th St |
$43.70 | 12,669 | 10,367 |
|
Karen Mcdaniel
3004 Cumberland Ave |
$25.38 | 13,214 | 10,732 |
|
Charles A Moore
123 N 19Th St |
$26.41 | 13,350 | 11,799 |
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