Based on public Medicaid payment data.

Average Medicaid Office Visit Payments in Somerset, PA: $40.65

Avg. Paid

$40.65

Range

$4.00 – $154.43

Total Claims

36,611

Providers

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 Somerset, PA

Provider	Avg. Paid	Claims	Patients
Kathleen T Smith 329 S Pleasant Avenue	$16.33	13	13
Salvatore Lanasa 126 E Church St Ste 3200	$22.00	13	13
Lauren Catherine Mathias 329 S Pleasant Ave	$29.28	15	14
Stephanie M Gramling 329 S Pleasant Ave	$12.56	27	26
Adam W Turinsky 329 S Pleasant Ave	$19.07	28	26
Kristen Susannah Kozak Somerset Hospital	$43.35	29	27
Mohammad Javad Saadat 105 W Church St	$118.60	41	40
Genevieve Lynn Everett-Sigwalt 126 E Church St Ste 3100	$39.62	53	53
Gail Ann Palko 329 S Pleasant Avenue	$37.45	58	56
Somerset Health Services Inc 329 S Pleasant Ave	$36.39	69	46
Rajesh R Bajpai 223 South Pleasant Avenue	$39.64	78	75
Tammy R Keating 126 E Church St Ste 3400	$4.00	84	83
Zachary James Ankney 329 S. Pleasant Ave.	$36.21	88	88
David S Girdany 126 E Church St	$23.62	88	84
Natalie Kukucka 600 Aberdeen Dr	$35.65	119	108
Paul C Serra 329 S Pleasant Ave	$41.82	122	103
Yuko Gruber Gibson 329 S Pleasant Ave	$40.71	124	115
Darrell Rubin 126 E Church St	$154.43	156	148
Ashley Lea Peterman-Barron 614 S Franklin Ave	$34.72	178	162
Ebere Maxwell Ugwanyi 126 E Church St Ste 3100	$27.82	195	191
Elizabeth Marie Tekulve Strini 225 S Center Ave	$54.92	242	233
Vincent E. Vena 225 S Center Ave	$53.77	242	241
Chantel House 203 E Patriot St Ste 100	$59.58	261	252
Victor F Novak 223 S Pleasant Ave Ste 302	$49.10	263	252
Rita N Camacho 329 S Pleasant Ave	$40.49	378	366
John Nicholson 329 S Pleasant Ave	$40.81	435	405
Vivek Sharma 126 E Church St Ste 2100	$38.30	467	456
Jae Ui Hong 321 E Main St	$54.77	547	526
Nilesh Patil 126 E Church St Ste 2100	$36.09	685	662
Taesun Moon 126 E Church St Ste 2300	$41.97	711	708
David R Battista 225 S Center Ave	$55.16	719	562
Tanya Jean Sargent 4324 Glades Pike	$50.09	864	825
Tami Lynne Judy 126 E Church St Ste 2300	$40.82	1,031	1,002
John Thomas Brennan 4324 Glades Pike	$48.57	1,042	1,002
Jayesh B Desai 126 E Church St	$30.80	1,155	1,141
Jacob Wayne Shipley 126 E Church St Ste 2400	$43.51	2,296	2,228
Ajay P Singh 126 East Church St	$39.55	2,641	2,485
Marlo H Marcheleovich 229 S Kimberly Ave	$38.06	2,811	2,610
Steven Agabegi 126 E Church St Ste 2100	$30.21	3,280	3,108
Charles E Camacho 126 E Church St	$38.68	4,161	3,679
Mark F Yaros 329 S Pleasant Avenue	$40.91	10,802	10,110

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 Somerset, PA?

Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Somerset, PA is $40.65 per claim, based on 36,611 claims from 41 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 Somerset, PA?

There are 41 Medicaid providers offering Office Visit related services in Somerset, PA according to public payment data.

What is the price range for Office Visit in Somerset, PA?

Medicaid reimbursement for Office Visit in Somerset, PA ranges from $4.00 to $154.43 per claim, with an average of $40.65. Private insurance and self-pay costs are typically higher than these Medicaid rates.

Average Medicaid Office Visit Payments in Somerset, PA: $40.65

Providers Offering Office Visit in Somerset, PA

What to Expect: Office Visit

Cost Components

Frequently Asked Questions

Office Visit in Other Cities

Brooklyn, NY

New York, NY

Los Angeles, CA

Chicago, IL

Bronx, NY

Phoenix, AZ

Houston, TX

Las Vegas, NV

Other Procedures in Somerset, PA

Case Management Services

Physical Therapy

Ambulance Transport

Speech Therapy

Eye Exam

Blood Work & Lab Tests

Chiropractic Care

EKG / ECG (Electrocardiogram)