Average Medicaid Office Visit Payments in Saint Marys, OH: $39.56
Avg. Paid
$39.56
Range
$26.62 – $79.70
Total Claims
27,480
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 Saint Marys, OH
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Thomas Joseph Zegarski
1010 Hager St |
$37.98 | 4,214 | 3,639 |
|
Eyra Adjoa Agudu
1067 Hager St |
$36.52 | 3,171 | 2,184 |
|
Efren C Aganon
1010 Hager St |
$37.23 | 2,216 | 1,994 |
|
Jennifer L Nyitray
975 Hager St |
$29.08 | 2,040 | 1,966 |
|
Matthew C Riesen
1132 Hager St |
$46.19 | 1,987 | 1,571 |
|
Whitney Nicole Clark
1140 S Knoxville Ave Ste B |
$46.92 | 1,940 | 1,703 |
|
Polly Fleet Train
1140 S Knoxville Ave Ste B |
$44.90 | 1,859 | 1,379 |
|
Natasha J Alexander
200 Saint Clair Ave |
$37.88 | 1,633 | 1,512 |
|
Katherine T. Zwiebel
200 Saint Clair Ave Ste 101 |
$39.12 | 1,312 | 1,207 |
|
Alex Michael Rowen
200 Saint Clair Ave |
$37.86 | 1,091 | 984 |
|
Bridget E Heckler
1140 S Knoxville Ave Ste B |
$43.97 | 825 | 654 |
|
Andrea Cristina Gonzalez
1140 S Knoxville Ave Ste A |
$50.00 | 759 | 640 |
|
Jacqueline S Shriver
1140 S Knoxville Ave Ste B |
$37.17 | 756 | 693 |
|
Christopher John Stucke
1013 E Spring St |
$26.62 | 716 | 630 |
|
Padmaja Chalasani
Grand Lake Primary Care At St Marys |
$27.36 | 693 | 612 |
|
Joint Township District Memorial Hospital
200 Saint Clair Ave |
$79.70 | 482 | 456 |
|
Alexander Clayton Mast
1010 Hager St |
$38.47 | 469 | 394 |
|
Justina Lynn Staroska
1140 S Knoxville Ave Ste B |
$35.53 | 411 | 324 |
|
Michael C Josey
1140 S Knoxville Ave Ste A |
$38.39 | 286 | 263 |
|
Mitchell E Nutt
1067 Hager St |
$43.66 | 271 | 213 |
|
Brittani Skelton
1140 S Knoxville Ave Ste B |
$43.28 | 247 | 208 |
|
Jayaben D Patel
1140 S Knoxville Ave Ste A |
$41.80 | 62 | 55 |
|
Kimberly Wiener
200 Saint Clair Ave |
$29.07 | 40 | 27 |
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 Marys, OH?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Saint Marys, OH is $39.56 per claim, based on 27,480 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 Saint Marys, OH?
There are 23 Medicaid providers offering Office Visit related services in Saint Marys, OH according to public payment data.
What is the price range for Office Visit in Saint Marys, OH?
Medicaid reimbursement for Office Visit in Saint Marys, OH ranges from $26.62 to $79.70 per claim, with an average of $39.56. 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 Marys, OH
Blood Work & Lab Tests
Avg $5.22
33,872 claims
Speech Therapy
Avg $33.25
22,414 claims
Non-Emergency Medical Transportation
Avg $26.31
19,738 claims
Emergency Room Visit
Avg $86.92
18,500 claims
Physical Therapy
Avg $45.12
15,836 claims
Chiropractic Care
Avg $14.51
9,940 claims
Psychiatric Evaluation
Avg $88.24
9,499 claims
Vaccines & Immunizations
Avg $13.45
9,344 claims