Average Medicaid Office Visit Payments in Prospect, CT: $50.06
Avg. Paid
$50.06
Range
$0.00 – $81.87
Total Claims
43,243
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 Prospect, CT
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Shayan Ozhen Riahi
166 Waterbury Rd |
$54.33 | 116 | 105 |
|
Catherine Gelinas
60 Waterbury Rd |
$37.80 | 179 | 150 |
|
Mary Maria Naccarato
166 Waterbury Rd |
$26.76 | 301 | 196 |
|
Jessica Magdalena Pelletier
166 Waterbury Rd Ste 104 |
$25.15 | 341 | 316 |
|
Archna Johar
166 Waterbury Rd Ste 201 |
$45.29 | 398 | 325 |
|
Aditi Mukherji
166 Waterbury Rd Ste 300 |
$30.35 | 658 | 596 |
|
Alexandra Elizabeth Ford
115 Waterbury Rd |
$49.62 | 702 | 619 |
|
Anthony Charles Marciano
60 Waterbury Rd |
$19.93 | 708 | 444 |
|
Carla M Rosato
15 Nancy Mae Ave |
$0.00 | 1,077 | 848 |
|
Lawrence N Kline
60 Waterbury Rd |
$37.47 | 1,080 | 873 |
|
Brittany Andreoli
73 Waterbury Rd |
$51.76 | 1,338 | 1,219 |
|
Olivia Rae Leach
73 Waterbury Rd |
$40.25 | 1,567 | 1,438 |
|
Alexander J Alvarez
166 Waterbury Rd |
$54.78 | 1,581 | 1,402 |
|
Amy Smith
8 Timber Hill Rd |
$52.55 | 1,715 | 1,328 |
|
Karl Benjamin Genovese
73 Waterbury Rd Ste 1 |
$58.61 | 2,506 | 2,336 |
|
Carlos S Almeida
166 Waterbury Rd |
$38.73 | 2,810 | 2,543 |
|
Renika N Mcleod-Labissiere
115 Waterbury Road |
$72.25 | 3,834 | 3,345 |
|
Sara Marie Miceli
166 Waterbury Rd Ste 104 |
$34.21 | 4,193 | 3,440 |
|
John A Testa
166 Waterbury Rd |
$81.87 | 4,197 | 3,444 |
|
Anthony N. Schore
166 Waterbury Rd Ste 104 |
$62.20 | 4,455 | 4,082 |
|
Thomas A Rockoff
166 Waterbury Rd Ste 104 |
$62.53 | 4,461 | 4,034 |
|
Tonya Goodman
104 Waterbury Rd |
$24.46 | 5,026 | 3,673 |
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 Prospect, CT?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Prospect, CT is $50.06 per claim, based on 43,243 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 Prospect, CT?
There are 22 Medicaid providers offering Office Visit related services in Prospect, CT according to public payment data.
What is the price range for Office Visit in Prospect, CT?
Medicaid reimbursement for Office Visit in Prospect, CT ranges from $0.00 to $81.87 per claim, with an average of $50.06. 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 Prospect, CT
Psychiatric Evaluation
Avg $53.50
20,878 claims
Eye Exam
Avg $28.13
20,063 claims
Speech Therapy
Avg $36.37
8,693 claims
Nursing Facility Care
Avg $15.76
6,098 claims
Physical Therapy
Avg $40.10
4,209 claims
Blood Work & Lab Tests
Avg $5.74
1,933 claims
Emergency Room Visit
Avg $71.17
1,895 claims
Dental Cleaning & Exam
Avg $28.26
1,889 claims