Office visits · procedure code 99213

Standard office visit cost in Pennsylvania

Hemlock Farms, PA has 56 filings for Office visit, established patient, 20 to 29 minutes. We need 100 before we will publish a market figure, so this page shows Pennsylvania instead and says so. These are the rates plans published under federal law. Not billed charges, and nothing here is scaled, adjusted or estimated to stand in for the market we do not hold.

State market

Standard office visit

PA · procedure code 99213

Statewide· n=54,278Pooled filings, payers not identified

We do not have a publishable distribution for Hemlock Farms, PA, so this is the PA market instead. The label above says so on purpose.

Medicare
$76
25th
$89
Median
$95
75th
$122
90th
$7625th
$89Median
$9575th
$12290th
$91Medicare

Middle price

$89

Half of this market is above it, half below

Middle half spans

$76 to $95

1.2x from low to high

The expensive end

$122

What the priciest providers charge

Medicare reference · Rest Of Pennsylvania (nearest published locality)

$91

Performed in an office

$56

Physician fee in a facility

Read this carefully. The facility figure is the physician fee only. When the same service happens in a hospital outpatient department, the hospital bills its own facility payment on top, and that amount is not in this dataset. So the lower number here does not mean the hospital is the cheaper site. It usually is not. We will not publish a total cost by site of service until we hold the facility payment.

Negotiated prices from published filings, reported only where the sample supports it. Statewide peer distribution, not a single-city sample. What plans have agreed to pay, not what a patient is billed. Filings as of July 20, 2026.

Reading it

What this distribution actually says.

The spread

The middle half of this market runs from $76 to $95, a 1.2x difference for the same procedure code in the same city. That gap is between contracts, not between quality.

Against Medicare

Medicare pays $91 for this service at its Rest Of Pennsylvania locality. We do not turn that into a percentage here, because the price above is Pennsylvania and that Medicare figure is one locality inside it. Two different maps do not divide.

The expensive end

One in ten filings sits at or above $122. If a plan's network is weighted toward that end, the difference does not show up in a premium quote. It shows up in the claims.

How wide the data runs

The carriers that filed for this procedure in this market. What each plan has agreed to pay, side by side. These are prices, not bills, so they do not show how often anyone needs it.

The same service elsewhere

Standard office visit across other markets.

Local · metro5 of 6 measured locally
MarketLow endMiddleHigh endProvidersBasis
Pennsylvania this page$76$89$9554,278Statewide
Philadelphia, PA$75$89$12318,204Local · metro
Pittsburgh, PA$76$86$9215,883Local · metro
Allentown, PA$80$92$1073,567Local · metro
Harrisburg, PA$77$90$1062,984Local · metro
Scranton, PA$78$89$921,526Local · metro

Put this in front of a client.

Every figure on this page carries its source, its scope and the date the corpus was built, so it survives being forwarded to someone who was not in the meeting.

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