Average Medicaid Office Visit Payments in Pontiac, IL: $36.11
Avg. Paid
$36.11
Range
$0.00 – $438.57
Total Claims
77,776
Providers
31
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 Pontiac, IL
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Rachel Skoumal
2500 W Reynolds St |
$64.03 | 27 | 26 |
|
Scott B O'Connor
1512 W Reynolds St Ste A |
$3.80 | 31 | 28 |
|
Taylor Morgan Miles
2500 W Reynolds St |
$438.57 | 71 | 59 |
|
Brittany Nicole Bursott
2500 W Reynolds St |
$93.42 | 73 | 71 |
|
Matthew Welch
2500 W Reynolds St |
$64.00 | 298 | 267 |
|
Angelito Fernandez
1506 W Reynolds St |
$55.96 | 376 | 318 |
|
William Lee Chang
2500 W Reynolds St |
$37.68 | 557 | 544 |
|
Candace Crystal Kudla
1506 W Reynolds St |
$45.21 | 653 | 413 |
|
Crystal Ann Cargill
1506 W Reynolds St |
$53.79 | 756 | 704 |
|
Lisa M. Watson
1506 W Reynolds St |
$50.73 | 763 | 703 |
|
Elaine Marie Carroll
1508 W Reynolds St |
$31.89 | 925 | 588 |
|
Sabitiyu K Folawiyo-Saba
700 W Lincoln St |
$105.83 | 1,028 | 941 |
|
Catherine Bachtold
2500 W Reynolds St |
$50.17 | 1,060 | 981 |
|
Amber Kay Jones
2500 W Reynolds St Ste 207 |
$47.63 | 1,172 | 1,041 |
|
Sharon R. Wissler
1506 W Reynolds St |
$58.70 | 1,202 | 1,060 |
|
Livingston Co Public Hlth Dept
1100 E Indiana Ave |
$12.00 | 1,334 | 593 |
|
Shai Nyi
2500 W Reynolds St |
$70.07 | 1,406 | 1,092 |
|
Justin Ray Hayes
2500 W Reynolds St |
$63.66 | 1,417 | 1,250 |
|
John Michael Rinker
2500 W Reynolds St |
$49.00 | 1,483 | 1,364 |
|
Briana Flori
920 W Custer Ave |
$54.31 | 1,777 | 1,708 |
|
Andrew John Farraher
2500 W Reynolds St |
$53.05 | 1,816 | 1,690 |
|
Andrew Wherley
2500 W Reynolds St |
$46.85 | 1,987 | 1,727 |
|
Sherri M Bowald
310 E Torrance Ave |
$46.16 | 1,988 | 1,674 |
|
Mukesh V Patel
2500 W Reynolds St |
$35.94 | 2,019 | 1,735 |
|
Calvin Moy
1506 W Reynolds St |
$47.03 | 4,751 | 4,039 |
|
Livingston County
310 E Torrance Ave |
$11.71 | 5,197 | 4,121 |
|
Saint James Hospital
1506 W Reynolds St |
$0.00 | 5,305 | 4,104 |
|
Steven S. Norris
2500 W Reynolds St |
$48.47 | 5,889 | 4,848 |
|
James Benjamin Mikeworth
2500 W Reynolds St |
$53.45 | 9,142 | 7,987 |
|
Tom Murphy
1506 W Reynolds St |
$45.60 | 10,850 | 9,311 |
|
Saint James Hospital
2500 W Reynolds St |
$0.00 | 12,423 | 9,524 |
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 Pontiac, IL?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Pontiac, IL is $36.11 per claim, based on 77,776 claims from 31 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 Pontiac, IL?
There are 31 Medicaid providers offering Office Visit related services in Pontiac, IL according to public payment data.
What is the price range for Office Visit in Pontiac, IL?
Medicaid reimbursement for Office Visit in Pontiac, IL ranges from $0.00 to $438.57 per claim, with an average of $36.11. 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 Pontiac, IL
Speech Therapy
Avg $12.95
66,956 claims
Substance Abuse Treatment
Avg $91.63
28,490 claims
Physical Therapy
Avg $35.74
28,032 claims
Emergency Room Visit
Avg $56.41
26,978 claims
Eye Exam
Avg $29.66
13,835 claims
Case Management Services
Avg $26.82
13,658 claims
Vaccines & Immunizations
Avg $7.29
11,239 claims
Behavioral & Mental Health Therapy
Avg $81.78
11,162 claims