Office Visit (New, Moderate-High) Cost in Pennsylvania
Office o/p new mod 45 min
Pennsylvania Average Cost (2026)
-0.2% vs national avgAverage across 2 Medicare localities in Pennsylvania
National Average
State Ranking
Cost by Region in Pennsylvania
| Region | Office Rate |
|---|---|
| metropolitan philadelphia | $183.85 |
| rest of pennsylvania | $170.15 |
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About Office Visit (New, Moderate-High) Costs in Pennsylvania
The average Medicare reimbursement for office visit (new, moderate-high) in Pennsylvania is $177.00 for an office setting and $117.79 in a hospital. This is close to the national average of $177.36.
Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. For this procedure in Pennsylvania, that would be roughly $35 for an office visit or $24 in a hospital setting.
Private insurance plans in Pennsylvania typically pay between 130% and 200% of Medicare rates for this procedure, putting the total somewhere between $230 and $354.
Without insurance, you may be able to negotiate a cash discount. Many providers in Pennsylvania will reduce their fees by 20% to 40% for self-pay patients. Always ask about cash pricing before scheduling your procedure.
Ways to Save on Office Visit (New, Moderate-High)
Compare Insurance Plans
Uninsured? Comparing marketplace plans in Pennsylvania could save you thousands on procedures like this.
Compare plans on eHealth →Try Telehealth First
Many consultations can be done virtually for $50-100, saving hundreds vs an in-person visit.
Book on Sesame Care →Save on Prescriptions
If this procedure leads to a prescription, check discount cards for up to 80% savings.
Check prices on GoodRx →Some links are affiliate links. We may earn a commission at no extra cost to you.
More ways to save →Other Procedures in Pennsylvania
Office Visit (New, Moderate-High) Cost by State
Office Visit (New, Moderate-High) in Pennsylvania: Frequently Asked Questions
How much does office visit (new, moderate-high) cost in Pennsylvania?
The average 2026 Medicare rate for office visit (new, moderate-high) (CPT 99204) in Pennsylvania is $177.00 in an office setting and $117.79 in a hospital. Private insurance typically pays $230 to $354, and self-pay cash prices often run $142 to $266.
Is office visit (new, moderate-high) cheaper in Pennsylvania than the national average?
Pennsylvania is close to the national average of $177.36. Across all states, Pennsylvania ranks #32 of 49 for this procedure. The cheapest state is Arkansas ($161.84) and the most expensive is Alaska ($222.54).
What will I pay out of pocket for office visit (new, moderate-high) in Pennsylvania with Medicare?
Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. In Pennsylvania that is roughly $35 for an office visit or $24 in a hospital setting.
How can I save on office visit (new, moderate-high) in Pennsylvania?
Ask providers for a cash or self-pay price before scheduling; many in Pennsylvania reduce fees 20% to 40% for self-pay patients. If you are uninsured, comparing marketplace plans, using telehealth for consultations, and checking prescription discount cards can cut costs further.