Average Medicaid Office Visit Payments in Sun Prairie, WI: $35.25
Avg. Paid
$35.25
Range
$0.41 – $61.99
Total Claims
41,412
Providers
51
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 Sun Prairie, WI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Holly F Anderson
10 Tower Dr |
$40.57 | 3,240 | 2,810 |
|
Keith E Cooper
10 Tower Dr |
$29.20 | 3,217 | 2,928 |
|
Joanne L Taylor
10 Tower Dr |
$35.12 | 3,083 | 2,808 |
|
Phillip L. Stall
10 Tower Dr |
$58.16 | 2,868 | 2,438 |
|
Kimberly Jean Berndt
131 Walmar Dr |
$37.10 | 2,552 | 1,873 |
|
Christopher L Kleppe
10 Tower Dr |
$41.70 | 2,119 | 1,873 |
|
Amanda E Kafka
10 Tower Dr |
$35.88 | 1,747 | 1,564 |
|
Anne E Arbet
10 Tower Dr |
$36.32 | 1,728 | 1,535 |
|
Kimberly K Ward
10 Tower Dr |
$27.47 | 1,697 | 1,481 |
|
Stephanie T Schrader
10 Tower Dr |
$39.15 | 1,531 | 1,372 |
|
Mihaela Pirau
10 Tower Dr |
$15.76 | 1,430 | 1,419 |
|
Alarise Jacquelyn Clay
1305 Prairie Rose Dr |
$34.59 | 1,224 | 1,159 |
|
Stephanie M Stenseth
10 Tower Dr |
$37.07 | 1,215 | 1,090 |
|
Laura B Pethan
10 Tower Dr |
$34.35 | 1,184 | 1,102 |
|
Adebowale Mofikoya
425 W Main St Ste 201 |
$25.89 | 1,119 | 967 |
|
David G Kass
10 Tower Dr |
$30.48 | 1,092 | 900 |
|
Nina M Kinnunen
10 Tower Dr |
$41.03 | 1,036 | 939 |
|
Danielle R Gindlesberger
10 Tower Dr |
$38.40 | 1,030 | 887 |
|
Sarah E Meyer
10 Tower Dr |
$37.89 | 864 | 761 |
|
Hilary Jahnke
10 Tower Dr |
$36.52 | 701 | 653 |
|
Megan E Kuikman
10 Tower Dr |
$35.51 | 666 | 594 |
|
Diana V Flint
10 Tower Dr |
$38.54 | 613 | 556 |
|
Carol Jan Morris
10 Tower Dr |
$24.49 | 579 | 467 |
|
Jacob J. Bryan
2651 Windsor St |
$21.41 | 549 | 500 |
|
Tyler D Zenner
10 Tower Dr |
$41.55 | 548 | 489 |
|
James E Quackenbush
2501 Ironwood Dr Apt 227 |
$18.24 | 469 | 439 |
|
David W Queoff
2651 Windsor St |
$24.64 | 397 | 371 |
|
Laura Shaw Kuhn
2651 Windsor St |
$34.02 | 338 | 303 |
|
Jodi Ann Wagner
3112 Egre Rd |
$0.41 | 280 | 245 |
|
Paige E Armga
2651 Windsor St |
$23.38 | 252 | 243 |
|
Chad J. Hess
10 Tower Dr |
$22.99 | 251 | 211 |
|
Michele L Newquist
10 Tower Dr |
$27.91 | 250 | 206 |
|
Ann M Byrne
1401 Okeeffe Ave Apt 216 |
$22.63 | 237 | 221 |
|
Kate M Blank
10 Tower Dr |
$35.53 | 224 | 200 |
|
Bruce Gordon Baranski
2168 County Road T |
$17.86 | 139 | 129 |
|
Kyle Peter D'Alberto
10 Tower Dr |
$34.63 | 112 | 105 |
|
Leo A Schug
10 Tower Dr |
$15.53 | 110 | 93 |
|
Nicole N. Weathers
2651 Windsor St |
$18.05 | 109 | 96 |
|
Eric Bauman
722 Lois Dr |
$58.41 | 95 | 84 |
|
Yusuf Abdullah
10 Tower Dr |
$61.99 | 91 | 83 |
|
Katharine Marie Greenfield
2651 Windsor St |
$26.05 | 70 | 64 |
|
Taylor M Lata
2651 Windsor St |
$36.28 | 62 | 52 |
|
Jackie L Sell
1226 School St |
$27.22 | 52 | 44 |
|
Michael J Aughey
10 Tower Dr |
$37.96 | 49 | 43 |
|
Robert M Greytak
10 Tower Dr |
$14.58 | 47 | 27 |
|
Sarah N Westby
2651 Windsor St |
$17.53 | 40 | 39 |
|
Lesley A Coert
2651 Windsor St |
$26.99 | 38 | 37 |
|
Kailene L Devries
10 Tower Dr |
$20.13 | 21 | 16 |
|
Annie Laura Henderson
10 Tower Dr |
$50.35 | 20 | 15 |
|
Jason M Ballweg
105 Clarmar Dr |
$17.96 | 14 | 13 |
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 Sun Prairie, WI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Sun Prairie, WI is $35.25 per claim, based on 41,412 claims from 51 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 Sun Prairie, WI?
There are 51 Medicaid providers offering Office Visit related services in Sun Prairie, WI according to public payment data.
What is the price range for Office Visit in Sun Prairie, WI?
Medicaid reimbursement for Office Visit in Sun Prairie, WI ranges from $0.41 to $61.99 per claim, with an average of $35.25. 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 Sun Prairie, WI
Personal Care Services
Avg $12.81
65,321 claims
Dental Cleaning & Exam
Avg $22.68
60,643 claims
Speech Therapy
Avg $12.48
49,556 claims
Physical Therapy
Avg $14.22
33,458 claims
Non-Emergency Medical Transportation
Avg $10.60
30,469 claims
Chiropractic Care
Avg $19.64
19,354 claims
Psychiatric Evaluation
Avg $67.18
10,540 claims
Dental Filling
Avg $74.58
7,474 claims