Average Medicaid Office Visit Payments in Saint Clair Shores, MI: $57.39
Avg. Paid
$57.39
Range
$0.00 – $275.08
Total Claims
122,313
Providers
44
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 Saint Clair Shores, MI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Ascension St. John Hospital
21000 E 12 Mile Rd Ste 111 |
$49.46 | 28,875 | 28,336 |
|
St Clair Shores Obstetrics And Gynecolgy, Plc
19714 E 10 Mile Rd |
$53.38 | 11,101 | 10,607 |
|
Anthony V Benenati Dpm Pc
27593 Harper |
$46.83 | 8,032 | 7,437 |
|
Mark Alrais Md Pc
21600 Harper Ave Ste 100 |
$73.01 | 7,454 | 6,782 |
|
Ascension Medical Group Michigan
21000 E 12 Mile Rd |
$46.67 | 5,708 | 5,438 |
|
Gs Jayakar Mdpc
21610 E 9 Mile Rd |
$75.41 | 5,479 | 5,148 |
|
Sailaja Datla Md Plc
21519 Harper Ave Ste 108 |
$82.47 | 5,448 | 5,079 |
|
Eastside Podiatry Pllc
24025 Greater Mack |
$44.78 | 4,712 | 4,288 |
|
Harper Urgent Care Pllc
25515 Harper Ave |
$66.04 | 4,577 | 4,487 |
|
Lakeshore Ear Nose And Throat Center Pc
21000 E 12 Mile Rd |
$62.89 | 4,089 | 4,035 |
|
Lakeview Medical Center Pc
23600 Harper Ave |
$78.51 | 4,045 | 3,624 |
|
Nikola Cengelova Conrad
21400 E 11 Mile Rd |
$59.67 | 4,002 | 3,414 |
|
Amer Alame Md Pc
29000 Little Mack Ave Ste A |
$78.71 | 3,891 | 3,838 |
|
Marjorie Joyce Cecil
24715 Little Mack Ave Ste 200 |
$35.79 | 3,489 | 3,042 |
|
Gi Medical Assoc Pc
28963 Little Mack Ave |
$57.83 | 2,976 | 2,871 |
|
Sacred Heart Rehabilitation Center, Inc.
19611 E 8 Mile Rd |
$74.81 | 2,960 | 2,569 |
|
Normandy Optical Company, Inc
23620 Harper Ave |
$49.87 | 2,880 | 2,656 |
|
Life Transition Services Llc
21031 Sunnydale St |
$42.53 | 2,161 | 1,907 |
|
Downriver Mental Health Clinic Pc
24715 Little Mack Ave |
$39.44 | 1,899 | 1,849 |
|
St Clair Orthopaedics And Sports Medicine Pc
23829 Little Mack Ave Ste 100 |
$27.71 | 1,631 | 1,555 |
|
Crystal Cooper
24911 Little Mack Ave Ste C |
$48.70 | 1,588 | 1,364 |
|
Aref I Hindawi Md Pllc
23600 Harper Ave |
$54.36 | 1,387 | 1,195 |
|
Seton Health Corporation Of Southeastern Michigan
21000 E 12 Mile Rd |
$82.42 | 853 | 830 |
|
Premier Vascular Associates, Pllc
29519 Harper Ave |
$68.07 | 741 | 709 |
|
Cecelia Kitakufe
20225 E 9 Mile Rd |
$56.92 | 514 | 496 |
|
Kidney Care Specialists Of Michigan Pc
29001 Harper Ave |
$61.25 | 488 | 482 |
|
Robert G Patrus Dpm Pc
26020 Harper Ave |
$30.46 | 253 | 230 |
|
Southeastern Michigan Medical Consultants Pc
21420 Harper Ave |
$45.79 | 251 | 246 |
|
Emily O Tallent
24911 Little Mack Ave |
$275.08 | 207 | 189 |
|
Andrew Bennett Sewell
21000 E 12 Mile Rd Ste 111 |
$73.66 | 121 | 118 |
|
Matthew Michael Brewster
24715 Little Mack Ave |
$56.67 | 95 | 91 |
|
Hawasli & Associates Surgical Specialists, P.C.
24911 Little Mack Ave |
$45.18 | 85 | 84 |
|
Robbie H Taha
25631 Little Mack Ave Ste 205 |
$35.96 | 56 | 53 |
|
Metro Detroit Kidney Associates
23995 Greater Mack Ave |
$58.30 | 50 | 48 |
|
Ascension Eastwood Behavioral Health
24055 Jefferson Ave |
$43.26 | 40 | 40 |
|
Saint Clair Shores Prompt Care Pllc
25631 Little Mack Avenue |
$77.94 | 40 | 37 |
|
Hassan Ben Nasser
21000 E 12 Mile Rd Ste 111 |
$77.09 | 30 | 29 |
|
Michael G. Taylor,M.D.P.L.C.
22646 E 9 Mile Rd |
$58.62 | 26 | 26 |
|
Christopher E Lai
29000 Little Mack Ave Ste B |
$0.00 | 17 | 17 |
|
Essential Care Family Medicine Pllc
21603 E 11 Mile Rd |
$82.51 | 13 | 12 |
|
Harper Chiropractic Center P C
27889 Harper Ave |
$0.00 | 13 | 13 |
|
Carrie L Anderson
20952 E 12 Mile Rd Ste 200 |
$34.59 | 12 | 12 |
|
Julie Anna Mrozek
27593 Harper Ave |
$12.46 | 12 | 12 |
|
Eastside Eye Physicians, Pc
25511 Little Mack Ave |
$68.02 | 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 Saint Clair Shores, MI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Saint Clair Shores, MI is $57.39 per claim, based on 122,313 claims from 44 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 Saint Clair Shores, MI?
There are 44 Medicaid providers offering Office Visit related services in Saint Clair Shores, MI according to public payment data.
What is the price range for Office Visit in Saint Clair Shores, MI?
Medicaid reimbursement for Office Visit in Saint Clair Shores, MI ranges from $0.00 to $275.08 per claim, with an average of $57.39. 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 Saint Clair Shores, MI
Substance Abuse Treatment
Avg $11.37
135,276 claims
Dental Cleaning & Exam
Avg $33.18
43,146 claims
Eye Exam
Avg $39.17
39,538 claims
Psychiatric Evaluation
Avg $60.99
34,601 claims
Physical Therapy
Avg $76.95
34,538 claims
Chiropractic Care
Avg $21.52
18,602 claims
Hearing Test (Audiometry)
Avg $12.64
18,224 claims
Urinalysis & Urine Tests
Avg $4.24
18,097 claims