Average Medicaid Office Visit Payments in Niles, MI: $9.36
Avg. Paid
$9.36
Range
$1.03 – $461.87
Total Claims
183,003
Providers
23
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 Niles, MI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Lakeland Immediate Care Center
60 N Saint Joseph Ave |
$5.52 | 60 | 59 |
|
Jamie Hugh Stone
1915 High Mdw N |
$27.05 | 71 | 60 |
|
Cardiovascular Diseases Of Niles, P.C.
24 N Saint Joseph Ave |
$58.66 | 82 | 77 |
|
Raul Hector Torres
4 Longmeadow Village Dr |
$51.58 | 95 | 83 |
|
John-Phillip Thomas Markovic
31 N Saint Joseph Ave |
$38.59 | 143 | 135 |
|
Cicely Moreno
4 Longmeadow Village Dr |
$72.79 | 226 | 176 |
|
David Michael Mcintosh
2002 S 11Th St |
$50.74 | 254 | 215 |
|
Max Schaefer
4 Longmeadow Village Dr |
$36.93 | 311 | 240 |
|
Leanne M Miller
2002 S 11Th St |
$88.70 | 347 | 303 |
|
Christopher H Faris
719 East Main Street |
$24.96 | 358 | 346 |
|
Greater Niles Cardiology Pc
24 N Saint Joseph Ave |
$40.42 | 417 | 402 |
|
Glenda M Gensolin
24 N Saint Joseph Ave Ste C2 |
$461.87 | 448 | 370 |
|
Alexandria Caroline Roden
4 Longmeadow Village Dr |
$37.29 | 484 | 406 |
|
Lakeland Immediate Care Center
60 N Saint Joseph Ave |
$34.44 | 675 | 595 |
|
Niles Vision Clinic, P.C.
9 S Saint Joseph Ave |
$45.69 | 980 | 926 |
|
James E Strycker
2002 S 11Th St |
$55.89 | 1,148 | 1,000 |
|
Benjamin Francis Erhardt
2002 S 11Th St |
$46.30 | 1,379 | 1,319 |
|
Dr Henderson Judy Md Family Medicine Pllc
24 N Saint Joseph Ave |
$74.08 | 1,529 | 1,187 |
|
Todd W Haney
2002 S 11Th St |
$65.00 | 3,406 | 3,092 |
|
Niles Foot Clinic, Pc
201 N 17Th St |
$49.72 | 4,285 | 4,189 |
|
Ashley Marie Fugate
2002 S 11Th St |
$60.86 | 6,990 | 5,586 |
|
Lakeland Immediate Care Center
1951 Oak St |
$1.85 | 49,702 | 44,967 |
|
Lakeland Community Hospital Watervliet
2002 S 11Th St |
$1.03 | 109,613 | 102,437 |
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 Niles, MI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Niles, MI is $9.36 per claim, based on 183,003 claims from 23 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 Niles, MI?
There are 23 Medicaid providers offering Office Visit related services in Niles, MI according to public payment data.
What is the price range for Office Visit in Niles, MI?
Medicaid reimbursement for Office Visit in Niles, MI ranges from $1.03 to $461.87 per claim, with an average of $9.36. 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 Niles, MI
Vaccines & Immunizations
Avg $0.81
91,957 claims
Psychiatric Evaluation
Avg $52.49
40,027 claims
Dental Cleaning & Exam
Avg $56.68
39,864 claims
Eye Exam
Avg $39.75
24,195 claims
Ambulance Transport
Avg $109.22
21,565 claims
Blood Work & Lab Tests
Avg $0.92
12,687 claims
Dental Filling
Avg $119.87
12,519 claims
Urinalysis & Urine Tests
Avg $0.16
8,869 claims