Average Medicaid Office Visit Payments in Middletown, NJ: $55.03
Avg. Paid
$55.03
Range
$3.31 – $81.27
Total Claims
20,197
Providers
15
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 Middletown, NJ
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Dalene Cheek Evans
480 Red Hill Rd |
$74.56 | 26 | 24 |
|
Emmet Theodore Fenichel
18 Leonardville Rd |
$43.68 | 30 | 27 |
|
Delia Dobrescu
1270 Highway 35 |
$54.13 | 51 | 51 |
|
Mary A Grove
1003 Abby Rd |
$81.27 | 66 | 47 |
|
Denise J Force
950 State Route 35 |
$3.79 | 137 | 120 |
|
Milagros Cappa
480 Red Hill Rd |
$80.99 | 207 | 197 |
|
Nolan Brodskiy
480 Red Hill Rd |
$17.31 | 361 | 291 |
|
Memorial Sloan Kettering Monmouth
480 Red Hill Rd |
$23.39 | 441 | 280 |
|
Paul Joseph Luparello
1270 Highway 35 |
$51.01 | 461 | 432 |
|
William Christian Anania
112 Tindall Rd |
$32.35 | 655 | 594 |
|
Russell A Gross
1270 Highway 35 |
$46.24 | 706 | 667 |
|
Mithun Sivadasan
1270 State Route 35 Ste 1 |
$30.59 | 847 | 682 |
|
Cheryl Roman
15 Southview W |
$3.31 | 1,420 | 1,270 |
|
Salvatore Sciurba
1000 Route 35 Ste 200 |
$62.14 | 6,248 | 5,929 |
|
Debra Harmady
1275 Highway 35 |
$66.75 | 8,541 | 7,528 |
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 Middletown, NJ?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Middletown, NJ is $55.03 per claim, based on 20,197 claims from 15 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 Middletown, NJ?
There are 15 Medicaid providers offering Office Visit related services in Middletown, NJ according to public payment data.
What is the price range for Office Visit in Middletown, NJ?
Medicaid reimbursement for Office Visit in Middletown, NJ ranges from $3.31 to $81.27 per claim, with an average of $55.03. 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 Middletown, NJ
Vaccines & Immunizations
Avg $19.01
5,611 claims
Physical Therapy
Avg $14.52
4,171 claims
Blood Work & Lab Tests
Avg $14.69
3,078 claims
Ambulance Transport
Avg $35.09
2,374 claims
Speech Therapy
Avg $28.59
1,917 claims
EKG / ECG (Electrocardiogram)
Avg $5.09
655 claims
Dental Cleaning & Exam
Avg $30.16
505 claims
Skin Biopsy & Lesion Removal
Avg $60.32
412 claims