Based on public Medicaid payment data.

Average Medicaid Office Visit Payments in Tonawanda, NY: $49.49

Avg. Paid

$49.49

Range

$8.12 – $156.62

Total Claims

40,649

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 Tonawanda, NY

Provider	Avg. Paid	Claims	Patients
Michael Edward Merhige 2447 Sheridan Dr	$28.48	13	13
Allison Rose Arida 1491 Sheridan Dr	$8.12	14	12
Sharon Lynn Schutz 4244 Delaware Avenue	$76.33	15	14
Chelsea Woods 1370 Niagara Falls Blvd	$67.43	26	26
Mark Simon Finkelstein 1540 Ellicott Creek Rd	$27.56	27	26
Ashley Anne Ciresi 1370 Niagara Falls Blvd	$62.41	29	28
Richard Andrew Carlson Jr 1491 Sheridan Dr	$47.47	32	31
Anne Brundin 1370 Niagara Falls Blvd	$55.34	32	28
Maurice M Gelia 1540 Ellicott Creek Rd	$45.51	40	37
Francis Patrick O'Day 1110 Colvin Blvd	$11.92	41	41
Joseph Vincent Mure 2465 Sheridan Dr	$55.38	49	43
David R Kraus 545 Delaware St	$40.19	56	52
William H Stephan 4080 Delaware Ave	$27.89	57	56
Kaylee Lyn Mcrae 1491 Sheridan Dr	$11.84	63	59
Sarah Jean Adams 2465 Sheridan Dr	$31.45	63	59
George Vasiliadis 190 Main St	$25.02	65	62
Latrice Marie Gillis 72 Evergreen Dr	$30.83	74	66
Annmarie M Lally 533 Niagara St	$67.54	75	73
Carolyn Doyle 1208 Niagara Falls Blvd	$17.78	132	129
Kariann Melissa Womer 1491 Sheridan Dr Ste 100	$47.58	289	280
Tatyana Manzik 1208 Niagara Falls Blvd	$38.42	306	297
Kimberly Joanne Wilkins 2465 Sheridan Dr	$50.97	313	305
Sarah Sheehan Cleveland 1491 Sheridan Dr	$42.76	381	366
Ashley Ann Coe 2465 Sheridan Drive	$31.91	401	320
Terry Jo Brooks-Devlin 612 Adam St	$156.62	440	298
Shelby Miranda Hall 1430 Colvin Bvld	$97.55	445	436
Jenny T. Bagen 1405 Sheridan Dr	$45.71	651	626
Spenser Alan Soldano 1540 Ellicott Creek Rd	$31.74	877	821
Matthew Albert Mavissakalian 2540 Sheridan Dr	$70.36	1,009	1,000
Connie Woroszylo 1751 Sheridan Dr	$53.86	1,145	1,118
Rajiv Jain 1491 Sheridan Dr	$40.74	1,555	1,489
Kaitlyn S Domres 2465 Sheridan Dr	$47.78	1,632	1,558
William J Belles 2545 Sheridan Dr	$69.64	1,664	1,615
Shawn Robert Campbell 1491 Sheridan Dr	$42.19	1,855	1,788
Cassondra Leigh Barbara 1751 Sheridan Dr	$67.42	1,889	1,873
Alexis J Packman 1751 Sheridan Dr	$91.55	2,194	2,118
Allison Elizabeth Bolton 1751 Sheridan Dr	$72.37	2,339	2,319
Barbara Spatafora 1208 Niagara Falls Blvd	$20.83	3,458	3,323
Ayesha Zaheer Butt 300 Two Mile Creek Rd	$40.41	4,612	4,411
Qamrunnisa Rahman 300 Two Mile Creek Rd	$44.22	5,633	5,278
Nadia Polataiko 300 Two Mile Creek Rd	$39.95	6,658	6,281

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 Tonawanda, NY?

Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Tonawanda, NY is $49.49 per claim, based on 40,649 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 Tonawanda, NY?

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

What is the price range for Office Visit in Tonawanda, NY?

Medicaid reimbursement for Office Visit in Tonawanda, NY ranges from $8.12 to $156.62 per claim, with an average of $49.49. Private insurance and self-pay costs are typically higher than these Medicaid rates.

Average Medicaid Office Visit Payments in Tonawanda, NY: $49.49

Providers Offering Office Visit in Tonawanda, NY

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 Tonawanda, NY

Home Health Visit

Speech Therapy

Dental Cleaning & Exam

Durable Medical Equipment (DME)

Non-Emergency Medical Transportation

Blood Work & Lab Tests

Physical Therapy

Emergency Room Visit