Average Medicaid Office Visit Payments in Spruce Pine, NC: $48.90
Avg. Paid
$48.90
Range
$0.00 – $73.37
Total Claims
21,746
Providers
20
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 Spruce Pine, NC
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Marvin Walker
54 Hill St |
$25.80 | 14 | 13 |
|
Jo Ellen Inman-Puckett
31 Swiss Pine Ct |
$0.00 | 15 | 15 |
|
Ashley Williams
189 Hospital Dr |
$0.00 | 16 | 16 |
|
Tonya Lynn Hensley
167 Locust St Ste 204 |
$56.28 | 34 | 33 |
|
Doyle Lyn Shelton
189 Hospital Dr Ste A |
$37.14 | 34 | 30 |
|
Cindy Blackwell Aldridge
11728 S 226 Hwy |
$31.05 | 46 | 33 |
|
Megan Robinson Vestal
88 Hospital Dr |
$39.72 | 117 | 94 |
|
Robert Lloyd Van Brederode
537 Altapass Hwy |
$27.41 | 119 | 95 |
|
Michelle Long
11728 S 226 Hwy |
$26.67 | 254 | 230 |
|
Hayley Marie Pionk
11728 S 226 Hwy |
$11.12 | 270 | 234 |
|
Elizabeth Thomas Sparks
215 Skyview Cir |
$15.27 | 388 | 309 |
|
Dwight James Willett
11728 S 226 Hwy |
$9.11 | 415 | 329 |
|
Lyndsay Jensen Edwards
11728 S 226 Hwy |
$4.64 | 441 | 408 |
|
Stephen William North
11728 S 226 Hwy |
$28.18 | 458 | 400 |
|
Mckenzie Dee Angel
1158 Greenwood Rd |
$35.52 | 569 | 388 |
|
Joshua M Newton
167 Locust St Ste 216 |
$52.34 | 609 | 462 |
|
Karen Peterson
88 Hospital Dr |
$52.66 | 643 | 478 |
|
Brie Michele Folkner
537 Altapass Hwy Ste C |
$44.97 | 3,666 | 2,425 |
|
Rebekah Smith
88 Hospital Dr |
$12.26 | 3,851 | 2,225 |
|
Jill R Czaja
7968 Hwy 19E |
$73.37 | 9,787 | 8,488 |
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 Spruce Pine, NC?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Spruce Pine, NC is $48.90 per claim, based on 21,746 claims from 20 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 Spruce Pine, NC?
There are 20 Medicaid providers offering Office Visit related services in Spruce Pine, NC according to public payment data.
What is the price range for Office Visit in Spruce Pine, NC?
Medicaid reimbursement for Office Visit in Spruce Pine, NC ranges from $0.00 to $73.37 per claim, with an average of $48.90. 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
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Las Vegas, NV
Avg $54.47
8,578,324 claims · 3512 providers
Other Procedures in Spruce Pine, NC
Personal Care Services
Avg $119.60
126,426 claims
Blood Work & Lab Tests
Avg $5.44
42,940 claims
Emergency Room Visit
Avg $119.08
38,939 claims
Durable Medical Equipment (DME)
Avg $25.35
18,728 claims
Case Management Services
Avg $175.39
15,512 claims
Urinalysis & Urine Tests
Avg $3.75
9,729 claims
Nursing Facility Care
Avg $12.17
7,811 claims
EKG / ECG (Electrocardiogram)
Avg $13.60
5,745 claims