Average Medicaid Office Visit Payments in Monaca, PA: $42.36
Avg. Paid
$42.36
Range
$0.94 – $102.04
Total Claims
21,912
Providers
18
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 Monaca, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Arthur Sonberg
3452 Brodhead Rd |
$36.84 | 13 | 12 |
|
Danielle Helen Pontus-Alvarado
3944 Brodhead Rd Ste 7B |
$67.85 | 17 | 17 |
|
Nicole Marie Maietta
3942 Brodhead Rd |
$34.48 | 26 | 25 |
|
Krishna K. Kasi
3542 Brodhead Rd |
$83.30 | 31 | 25 |
|
Debra Lynn Hall
79 Wagner Rd |
$35.69 | 79 | 79 |
|
Atac Turkay
79 Wagner Rd |
$49.73 | 178 | 176 |
|
Matthew Paul Sniezek
79 Wagner Rd |
$38.68 | 346 | 335 |
|
William Joseph Rust
79 Wagner Rd |
$42.35 | 384 | 372 |
|
Darrick Richard Dominick
79 Wagner Rd Ste 103 |
$45.76 | 405 | 377 |
|
Patricia Porche
300 Frankfort Rd |
$0.94 | 536 | 500 |
|
Lindsey Rae Hyatt
3944 Brodhead Rd Ste 7B |
$57.21 | 665 | 653 |
|
Morgan Bailey
3944 Brodhead Rd Ste 7B |
$65.27 | 701 | 691 |
|
Janessa Lynn Morris
79 Wagner Rd Ste 200 |
$33.07 | 735 | 696 |
|
Scott Stern
3942 Brodhead Rd |
$102.04 | 1,348 | 1,314 |
|
Benjamin Alberto Laracuente
3468 Brodhead Rd Ste 11 |
$34.13 | 1,665 | 1,480 |
|
Gerard Anthony Myers
3627 Brodhead Rd |
$46.69 | 2,850 | 2,346 |
|
Matthew Britt Coombs
3950 Brodhead Rd |
$36.74 | 5,804 | 5,593 |
|
Gregg S Zernich
3950 Brodhead Rd |
$34.90 | 6,129 | 5,878 |
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 Monaca, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Monaca, PA is $42.36 per claim, based on 21,912 claims from 18 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 Monaca, PA?
There are 18 Medicaid providers offering Office Visit related services in Monaca, PA according to public payment data.
What is the price range for Office Visit in Monaca, PA?
Medicaid reimbursement for Office Visit in Monaca, PA ranges from $0.94 to $102.04 per claim, with an average of $42.36. 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 Monaca, PA
Substance Abuse Treatment
Avg $93.90
20,292 claims
Speech Therapy
Avg $11.36
7,636 claims
Dental Cleaning & Exam
Avg $27.37
7,597 claims
Physical Therapy
Avg $27.92
4,782 claims
Home Health Visit
Avg $46.65
4,726 claims
Chiropractic Care
Avg $11.14
4,577 claims
Eye Exam
Avg $45.93
3,361 claims
X-Ray
Avg $8.32
2,693 claims