Average Medicaid Office Visit Payments in Middletown, PA: $58.52
Avg. Paid
$58.52
Range
$32.35 – $89.71
Total Claims
18,291
Providers
20
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, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Viral P Patel
1025 W Harrisburg Pike |
$50.52 | 6,978 | 6,600 |
|
William Jeffrey Albright
1025 W Harrisburg Pike |
$48.65 | 3,047 | 2,889 |
|
Munima Nasir
3100 Schoolhouse Rd |
$83.08 | 2,667 | 2,554 |
|
Carol A Baase
3100 Schoolhouse Rd |
$75.16 | 1,830 | 1,729 |
|
Kevin Andrew Wile
3100 Schoolhouse Rd |
$71.13 | 1,040 | 1,008 |
|
Shekiba Shahabzada
1025 W Harrisburg Pike |
$32.35 | 941 | 864 |
|
Alexander Toppin
1025 W Harrisburg Pike |
$62.55 | 249 | 235 |
|
Jayson Loeffert
3100 Schoolhouse Rd |
$67.52 | 227 | 225 |
|
Kate Elizabeth Garvin
1025 W Harrisburg Pike |
$61.00 | 210 | 195 |
|
Andrew Thompson
3100 Schoolhouse Rd |
$65.00 | 192 | 183 |
|
Kristie Marie Pepper
3100 Schoolhouse Rd |
$41.54 | 159 | 158 |
|
Elizabeth A Egitto
1025 W Harrisburg Pike |
$51.29 | 153 | 151 |
|
Laura D Smith
1025 W Harrisburg Pike |
$60.72 | 126 | 122 |
|
William J Curry
3100 Schoolhouse Rd |
$52.33 | 124 | 119 |
|
Andrew Lutzkanin
3100 Schoolhouse Rd |
$71.79 | 119 | 114 |
|
Michael John Fedor
3100 Schoolhouse Rd |
$37.47 | 72 | 69 |
|
Nicolette Sara Marie Hartman
3100 Schoolhouse Rd |
$36.55 | 67 | 61 |
|
Taraneh Soleymani
3100 Schoolhouse Rd |
$89.71 | 58 | 54 |
|
Melissa Ann Mills
586 Fulling Mill Rd |
$65.30 | 18 | 15 |
|
Courtney Lynne Lennon
3100 Schoolhouse Rd |
$86.71 | 14 | 14 |
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, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Middletown, PA is $58.52 per claim, based on 18,291 claims from 20 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, PA?
There are 20 Medicaid providers offering Office Visit related services in Middletown, PA according to public payment data.
What is the price range for Office Visit in Middletown, PA?
Medicaid reimbursement for Office Visit in Middletown, PA ranges from $32.35 to $89.71 per claim, with an average of $58.52. 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