Average Medicaid Office Visit Payments in Tyrone, PA: $32.83
Avg. Paid
$32.83
Range
$0.36 – $58.80
Total Claims
8,500
Providers
11
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 Tyrone, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Ronald W Gregory
1400 Penna Ave |
$54.08 | 155 | 151 |
|
Jason Henninger
863 S Lincoln Ave |
$40.58 | 195 | 174 |
|
Ryan Anthony Lani
1400 Pennsylvania Ave |
$50.79 | 394 | 370 |
|
Victor H Santillan
200 Hospital Dr |
$45.39 | 402 | 385 |
|
Bradley A. Barter
221 Hospital Dr |
$33.72 | 402 | 371 |
|
Kishor D Patel
225 Hospital Dr |
$0.60 | 465 | 401 |
|
Michael R Halter
225 Hospital Dr |
$0.69 | 550 | 530 |
|
Adam Powers
509 W 20Th St |
$46.10 | 552 | 522 |
|
Anupamaa Srivastava-Sinha
221 Hospital Dr Ste 6 |
$0.36 | 1,393 | 1,256 |
|
Marianne L Shaw
154 Hospital Dr |
$58.80 | 1,504 | 1,463 |
|
Roy Rolando Pazmino
200 Hospital Dr |
$38.54 | 2,488 | 2,118 |
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 Tyrone, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Tyrone, PA is $32.83 per claim, based on 8,500 claims from 11 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 Tyrone, PA?
There are 11 Medicaid providers offering Office Visit related services in Tyrone, PA according to public payment data.
What is the price range for Office Visit in Tyrone, PA?
Medicaid reimbursement for Office Visit in Tyrone, PA ranges from $0.36 to $58.80 per claim, with an average of $32.83. 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 Tyrone, PA
Speech Therapy
Avg $8.83
14,402 claims
Substance Abuse Treatment
Avg $8.80
13,452 claims
Physical Therapy
Avg $7.19
7,060 claims
Emergency Room Visit
Avg $97.23
7,048 claims
Chiropractic Care
Avg $11.25
937 claims
Psychiatric Evaluation
Avg $0.90
699 claims
Hearing Test (Audiometry)
Avg $0.00
502 claims
Blood Work & Lab Tests
Avg $8.51
443 claims