Average Medicaid Office Visit Payments in Setauket, NY: $56.64
Avg. Paid
$56.64
Range
$0.00 – $157.45
Total Claims
15,294
Providers
19
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 Setauket, NY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Katiuschka Nunez
4 Brewster Ct |
$0.00 | 2,969 | 2,652 |
|
Jessica Malena Carbajal Caceda
46 Route 25A Ste 4 |
$45.21 | 1,915 | 1,765 |
|
Christopher Xikis
7 S Jersey Ave |
$33.70 | 1,550 | 1,215 |
|
Debra Emery
4 Conscience Meadow Path |
$59.36 | 1,461 | 1,085 |
|
Jeannelle Chaperon
200 Main St Ste 2&6 |
$104.30 | 1,422 | 884 |
|
Rachel B Davis
24 Research Way Ste 500 |
$126.97 | 1,284 | 1,281 |
|
Kerim Odekon
205 N Belle Mead Rd |
$45.92 | 1,027 | 988 |
|
Nicole Paige Polimeni
4 Kenwood St |
$74.36 | 1,016 | 979 |
|
Rahuldev S. Bhalla
24 Research Way |
$73.23 | 778 | 721 |
|
Tanya Roth Adams
200 Main St |
$46.47 | 487 | 416 |
|
Lana Dhamija
4 Technology Dr Ste 180 |
$99.24 | 434 | 425 |
|
Samantha Ilana Muhlrad
14 Technology Dr |
$122.86 | 402 | 386 |
|
Louis Thomas Verardo
181 Bellemeade Rd |
$36.83 | 271 | 253 |
|
Susmita Pati
4 Technology Dr |
$38.92 | 83 | 83 |
|
Robert O'Keefe
200 Main Street |
$114.82 | 57 | 54 |
|
Laurie E. Panesar
4 Technology Drive |
$95.79 | 48 | 46 |
|
Diana Janet Garretto
6 Technology Drive |
$94.20 | 34 | 27 |
|
Christine A Martorana
200 Main St Ste 2 |
$100.79 | 30 | 28 |
|
Jeffrey Porte
200 Main Street |
$157.45 | 26 | 26 |
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 Setauket, NY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Setauket, NY is $56.64 per claim, based on 15,294 claims from 19 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 Setauket, NY?
There are 19 Medicaid providers offering Office Visit related services in Setauket, NY according to public payment data.
What is the price range for Office Visit in Setauket, NY?
Medicaid reimbursement for Office Visit in Setauket, NY ranges from $0.00 to $157.45 per claim, with an average of $56.64. 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 Setauket, NY
Dental Cleaning & Exam
Avg $37.20
16,109 claims
X-Ray
Avg $8.22
8,315 claims
Speech Therapy
Avg $111.42
4,759 claims
Blood Work & Lab Tests
Avg $3.83
3,834 claims
Podiatry (Foot Care)
Avg $0.40
3,709 claims
Ultrasound
Avg $113.37
3,247 claims
Dental Filling
Avg $80.78
3,202 claims
Eye Exam
Avg $18.32
2,531 claims