Average Medicaid Office Visit Payments in Plymouth, WI: $31.92
Avg. Paid
$31.92
Range
$19.72 – $39.70
Total Claims
19,178
Providers
25
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 Plymouth, WI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Mauricio E Palencia
2600 Kiley Way |
$39.26 | 4,301 | 4,014 |
|
Derek J Harmelink
2600 Kiley Way |
$25.98 | 3,578 | 3,280 |
|
Andrew Bradford Ingraham
2600 Kiley Way |
$31.99 | 2,650 | 2,491 |
|
Robert R Mckibben
2600 Kiley Way |
$28.49 | 2,232 | 2,071 |
|
Anthony Lazaro
2600 Kiley Way |
$38.37 | 1,194 | 1,094 |
|
Robert M Horth
2631 Eastern Ave |
$22.21 | 929 | 778 |
|
Kao Feng Moua
2600 Kiley Way |
$30.44 | 534 | 472 |
|
Juliane R Nevers
2600 Kiley Way |
$33.67 | 490 | 455 |
|
Leah Fabis
One Persnickety Way |
$34.12 | 487 | 428 |
|
Dena Horvath
2600 Kiley Way |
$35.16 | 416 | 382 |
|
Dharmesh Murthy
2600 Kiley Way |
$28.55 | 402 | 359 |
|
Joseph Allen Weber
2600 Kiley Way |
$29.38 | 399 | 376 |
|
Michael Roy Lunde
N7135 Rocky Knoll Pkwy |
$28.28 | 379 | 330 |
|
Katie E Thompson
2600 Kiley Way |
$32.09 | 351 | 320 |
|
Jennifer Ann-Gabrys Rench
825 Walton Dr |
$38.62 | 201 | 166 |
|
Sarah Jabs
2600 Kiley Way |
$29.25 | 189 | 170 |
|
Heather Meeusen
825 Walton Dr |
$24.49 | 128 | 110 |
|
Melissa Virant
825 Walton Dr |
$26.50 | 116 | 96 |
|
Mark William Sharon
2636 Eastern Ave |
$39.70 | 97 | 87 |
|
Lynnett M Wilderman
2600 Kiley Way |
$30.45 | 27 | 26 |
|
Matthew Edwin Leafblad
2600 Kiley Way |
$33.54 | 25 | 25 |
|
Rebecca Rose Hoerth
2631 Eastern Ave |
$26.60 | 14 | 14 |
|
Angela Meg Montague
825 Walton Dr |
$30.56 | 14 | 14 |
|
Cynthia Nackers Munson
710 Eastern Ave |
$19.72 | 13 | 13 |
|
Mary E Arenberg
1000 Eastern Ave |
$25.25 | 12 | 12 |
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 Plymouth, WI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Plymouth, WI is $31.92 per claim, based on 19,178 claims from 25 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 Plymouth, WI?
There are 25 Medicaid providers offering Office Visit related services in Plymouth, WI according to public payment data.
What is the price range for Office Visit in Plymouth, WI?
Medicaid reimbursement for Office Visit in Plymouth, WI ranges from $19.72 to $39.70 per claim, with an average of $31.92. 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 Plymouth, WI
Personal Care Services
Avg $11.30
40,107 claims
Speech Therapy
Avg $11.86
22,033 claims
Chiropractic Care
Avg $17.44
18,910 claims
Physical Therapy
Avg $18.11
14,529 claims
Non-Emergency Medical Transportation
Avg $10.78
13,131 claims
Psychiatric Evaluation
Avg $20.45
10,535 claims
Eye Exam
Avg $12.84
2,676 claims
Nursing Facility Care
Avg $17.02
763 claims