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Connecticut

Cost of a Primary Care Doctor (Family Medicine) Visit
in Connecticut

Reviewed by Momentary Medical Group West PC

Connecticut ranks #26 out of 51 states for Primary Care Doctor (Family Medicine) visit costs, positioning it in the middle tier nationwide despite being home to several major insurance headquarters. Patients in Connecticut typically pay between $80 and $200 for Primary Care Doctor (Family Medicine) visits, with a median out-of-pocket cost of $93 based on negotiated insurance rates. The state maintains 58 active Primary Care Doctor (Family Medicine) providers across urban centers like Hartford and smaller communities, allowing patients to browse all providers in Connecticut to find the best match for their healthcare needs.

Average

$124

Median

$93

Lowest

$80

Highest

$200

Providers

58

National avg: $129Connecticut: $124

4% below national average

Compare Similar Procedures

How does family medicine visit compare to related procedures in Connecticut?

ProcedureCPTLowMedianHighProviders
Internal Medicine Visit

Standard office visit with an internist

99214$80$93$202158
Cardiologist Visit

Standard office visit with a cardiologist

99214$93$93$20725

Important: These are cost estimates only — not a quote and not medical advice.

The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 99214Office/outpatient visit, established patient, moderate complexity). They represent what a patient might pay without insurance.

Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.

This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.

Where this data comes from & what CPT 99214 covers

Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 99214 (Office/outpatient visit, established patient, moderate complexity), as mandated by the CMS Price Transparency Rule.

What CPT 99214 covers: the provider's professional fee for family medicine visit. It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.

How to read this data

Negotiated Rate

The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.

P5, Median, P95

P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.

What this does not tell you

These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.

Top Rated Family medicine physicians in Connecticut

Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across Connecticut

Connecticut's healthcare costs run approximately 14% above the national average, driven by the state's high cost of living and concentration of specialty medical centers along the I-95 corridor. The state's small geographic footprint creates less variation between urban and rural pricing compared to larger states, though proximity to New York's expensive healthcare market influences northern Connecticut rates.

Urban vs. Rural Provider Availability

Connecticut's dense population centers around Hartford, New Haven, and Bridgeport support multiple Primary Care Doctor (Family Medicine) options, while rural areas in the state's northwest and eastern regions may have limited choices. Urban practices often operate with higher overhead costs due to real estate prices but benefit from higher patient volumes that can support more efficient operations. Rural family medicine practices may charge less but face challenges maintaining profitability with smaller patient panels.

Facility Type and Overhead Costs

Major health systems like Yale New Haven Health and Hartford HealthCare dominate Connecticut's healthcare landscape, operating many Primary Care Doctor (Family Medicine) practices as hospital-affiliated clinics. These hospital-owned practices typically charge higher rates due to facility fees and administrative overhead compared to independent family medicine offices. Private practice physicians face increasing pressure to join larger systems, which can affect pricing and availability of direct-pay arrangements.

Insurance Market Competition in Connecticut

Connecticut's insurance market shows moderate concentration with Anthem, Cigna, and UHC holding significant market share, creating adequate competition for negotiated rates with Primary Care Doctor (Family Medicine) providers. The state's small size allows insurers to build comprehensive networks more easily than in larger states, though this can also limit provider leverage in rate negotiations. Connecticut's insurance department actively regulates rate increases, which can constrain dramatic year-over-year pricing changes for medical services.

Physician Supply and Demand in Connecticut

With 58 active Primary Care Doctor (Family Medicine) providers serving the state's 3.6 million residents, Connecticut maintains adequate but not abundant specialist availability in this field. The state's physician-to-population ratio exceeds the national average overall, though family medicine specifically faces workforce challenges as more medical graduates choose specialized fields. Limited residency positions in family medicine create ongoing supply constraints that support higher pricing power for established providers.

Cost by Procedure Type

Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Connecticut.

CPT 9921359 providers

Follow-up, low complexity

$93
Range: $61$137
CPT 9921458 providers

Follow-up, moderate complexity

$93
Range: $80$200
CPT 9921514 providers

Follow-up, high complexity

$187
Range: $80$315
CPT 9920357 providers

New patient, low complexity

$93
Range: $80$205
CPT 9920456 providers

New patient, moderate complexity

$93
Range: $82$307
CPT 9920513 providers

New patient, high complexity

$266
Range: $80$392

Costs shown are median negotiated rates. Your actual cost depends on your insurance plan and provider.

JP

Jayant Panwar

CEO, Momentary Labs · San Francisco, CA

Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.

The cost figures on this page reflect his ongoing work to make this data accessible to patients.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — Primary Care Doctor (Family Medicine) Costs in Connecticut

What is the average cost of a Primary Care Doctor (Family Medicine) visit in Connecticut without insurance?

Primary Care Doctor (Family Medicine) visits in Connecticut range from $80 to $200 for uninsured patients, with a median cost of $93 based on negotiated insurance rates. New patient visits typically cost more than follow-up appointments, and hospital-affiliated clinics often charge higher rates than independent practices. Many providers offer self-pay discounts of 10-30% when patients pay at the time of service.

Does Connecticut Medicaid cover Primary Care Doctor (Family Medicine) visits?

Yes, Connecticut expanded Medicaid under the Affordable Care Act, providing full coverage for Primary Care Doctor (Family Medicine) visits for eligible residents. Medicaid recipients typically pay no copay for primary care visits, though they must see providers who accept Medicaid rates. Coverage includes both preventive care and treatment visits, making family medicine services accessible to low-income Connecticut residents.

How do I find an affordable Primary Care Doctor (Family Medicine) near me in Connecticut?

Compare costs across different facility types, as independent practices typically charge less than hospital-affiliated clinics for Primary Care Doctor (Family Medicine) visits. Look for community health centers and federally qualified health centers (FQHCs) that offer sliding scale fees based on income. Ask about cash-pay discounts, which many Connecticut providers offer to reduce administrative costs for uninsured patients.

What is the difference in cost between an initial consultation and a follow-up visit?

New patient visits with a Primary Care Doctor (Family Medicine) in Connecticut cost $80-$206 depending on complexity, while established patient follow-ups range from $61-$200 based on the actual negotiated rates. Initial consultations typically involve comprehensive health histories and examinations, justifying the higher cost compared to focused follow-up visits. The median cost difference is approximately $20-40 between new and established patient visits.

Can I use an HSA or FSA to pay for a Primary Care Doctor (Family Medicine) visit in Connecticut?

Yes, Primary Care Doctor (Family Medicine) visits qualify as eligible medical expenses for both Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). You can use these pre-tax dollars to pay for copays, deductibles, and full visit costs when seeing out-of-network providers. Keep receipts for tax documentation, as the IRS requires proof of qualified medical expenses for HSA and FSA expenditures.

How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in Connecticut?

Telemedicine visits with Primary Care Doctor (Family Medicine) providers in Connecticut typically cost 20-30% less than in-person appointments, though exact pricing varies by provider and insurance coverage. Connecticut expanded telehealth coverage during the pandemic, and many insurers now cover virtual family medicine visits at the same copay rate as office visits. Some providers offer direct-pay telemedicine options for cash patients at reduced rates compared to traditional office visits.

Click a state to compare costs

Average Visit Cost

$80
$215

Office visit (CPT 99214)

Compare With Other States

RankStateAverage
1Nebraska
Range: $91$314
$215
2New Hampshire
Range: $101$282
$198
3Iowa
Range: $80$314
$187
4Maine
Range: $80$255
$180
5Minnesota
Range: $81$313
$162
6Wisconsin
Range: $73$313
$161
7California
Range: $70$250
$154
8Wyoming
Range: $80$251
$152
9Illinois
Range: $77$226
$148
10Massachusetts
Range: $80$271
$144
11Rhode Island
Range: $85$200
$143
12North Dakota
Range: $91$240
$141
13Texas
Range: $70$221
$139
14New Mexico
Range: $80$178
$138
15Vermont
Range: $107$166
$138
16Mississippi
Range: $67$249
$136
17Michigan
Range: $66$249
$134
18South Dakota
Range: $77$239
$132
19Hawaii
Range: $70$239
$131
20New York
Range: $78$200
$131
21Pennsylvania
Range: $73$228
$130
22Louisiana
Range: $69$222
$130
23Colorado
Range: $80$210
$126
24Connecticut
Range: $80$200
$124
25Oregon
Range: $80$204
$124
26Indiana
Range: $80$202
$123
27Ohio
Range: $70$201
$122
28Georgia
Range: $72$188
$122
29South Carolina
Range: $68$216
$121
30Washington
Range: $80$202
$121
31North Carolina
Range: $66$210
$119
32Nevada
Range: $48$182
$118
33Virginia
Range: $60$191
$116
34Arkansas
Range: $70$175
$116
35West Virginia
Range: $80$133
$115
36Florida
Range: $54$200
$115
37Idaho
Range: $75$179
$115
38New Jersey
Range: $53$188
$113
39Missouri
Range: $67$148
$113
40Kansas
Range: $76$158
$113
41Maryland
Range: $49$194
$112
42District of Columbia
Range: $53$199
$112
43Kentucky
Range: $80$170
$110
44Utah
Range: $60$180
$110
45Tennessee
Range: $70$168
$109
46Oklahoma
Range: $70$158
$104
47Arizona
Range: $63$168
$104
48Alabama
Range: $61$160
$100
49Delaware
Range: $58$123
$91
50Alaska
Range: $80$80
$80
51Montana
Range: $80$80
$80
Family Medicine Visit in Other States