Average Medicaid Office Visit Payments in Mt Pleasant, PA: $40.87
Avg. Paid
$40.87
Range
$27.47 – $89.60
Total Claims
22,637
Providers
22
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 Mt Pleasant, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Efren B Leonida
One Braddock Road Ave |
$42.42 | 4,003 | 3,677 |
|
Linda Shearer
6396 Route 819 S |
$71.02 | 3,282 | 3,231 |
|
Christopher Ross Horrell
828 W Main St |
$31.05 | 2,389 | 2,308 |
|
Jonathan M Wilson
508 S Church St Ste 100 |
$30.75 | 2,162 | 2,058 |
|
Andrew Schleihauf
508 S Church St Ste 200 |
$35.82 | 1,564 | 1,472 |
|
Samara Rubin
508 S Church St Ste 102 |
$37.76 | 1,428 | 1,317 |
|
Megan Klamerus
508 S Church St Ste 102 |
$37.95 | 1,345 | 1,258 |
|
Rajni Madaan
525 W Main St |
$38.20 | 1,097 | 1,031 |
|
Molly Castille
508 S Church St Ste 100 |
$32.76 | 1,060 | 1,030 |
|
Tiffany Rose Higgins
525 W Main St |
$31.03 | 1,019 | 980 |
|
Michael W Semelka
508 S Church St Ste 100 |
$27.47 | 903 | 871 |
|
Howard Brumberg
508 S Church St |
$27.83 | 709 | 676 |
|
Aster Assefa
603 N Church St |
$38.94 | 655 | 622 |
|
Abigail Irene Casey
508 S Church St Ste 100 |
$31.29 | 255 | 246 |
|
Sarfraz Ahmad
508 S Church St Ste 100 |
$42.47 | 233 | 227 |
|
Rachel Fasson Esposito
599 N Church St |
$35.53 | 177 | 173 |
|
Emilio R Navarro
599 N Church St |
$89.60 | 102 | 99 |
|
Vivian Boyer
508 S Church St Ste 102 |
$33.60 | 85 | 81 |
|
Jerome W Gera
508 S Church St Ste 100 |
$29.66 | 73 | 72 |
|
Murat Bankaci
609 N Church St |
$44.24 | 52 | 50 |
|
Benfauzi El-Attrache
508 S Church St |
$44.02 | 25 | 24 |
|
Young Kyu Lim
605 N Church St |
$32.37 | 19 | 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 Mt Pleasant, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Mt Pleasant, PA is $40.87 per claim, based on 22,637 claims from 22 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 Mt Pleasant, PA?
There are 22 Medicaid providers offering Office Visit related services in Mt Pleasant, PA according to public payment data.
What is the price range for Office Visit in Mt Pleasant, PA?
Medicaid reimbursement for Office Visit in Mt Pleasant, PA ranges from $27.47 to $89.60 per claim, with an average of $40.87. 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 Mt Pleasant, PA
Physical Therapy
Avg $27.51
18,241 claims
Blood Work & Lab Tests
Avg $5.95
9,430 claims
Chiropractic Care
Avg $12.29
6,578 claims
Emergency Room Visit
Avg $66.06
4,604 claims
Dental Cleaning & Exam
Avg $27.38
3,360 claims
EKG / ECG (Electrocardiogram)
Avg $7.58
2,561 claims
Ambulance Transport
Avg $81.81
1,278 claims
Echocardiogram
Avg $27.63
1,086 claims