Cost of a Primary Care Doctor (Family Medicine) Visit
in Delaware
Reviewed by Momentary Medical Group West PC
Delaware's small geographic footprint creates a concentrated healthcare market where the same Primary Care Doctor (Family Medicine) practice might serve patients from urban Wilmington to rural Sussex County beaches. Primary Care Doctor (Family Medicine) visits in Delaware typically cost between $58 and $123, with a median negotiated rate of $93 among the state's 4 active providers. Patients across the First State can browse all available Primary Care Doctor (Family Medicine) providers to find quality care within their budget.
Average
$91
Median
$93
Lowest
$58
Highest
$123
Providers
4
29% below national average
Compare Similar Procedures
How does family medicine visit compare to related procedures in Delaware?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Internal Medicine Visit Standard office visit with an internist | 99214 | $80 | $144 | $200 | 8 |
| Cardiologist Visit Standard office visit with a cardiologist | 99214 | $80 | $80 | $100 | 2 |
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 99214 — Office/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 Delaware
Dr. Marc Grobman, DO
Family Medicine Physician · Wilmington, DE
Dr. Mark Sordi, MD
Family Medicine Physician · Lewes, DE
Dr. Mhaidi Elmedkhar, MD
Family Medicine Physician · Middletown, DE
Dr. Heather Bittner-Fagan, MD
Family Medicine Physician · Wilmington, DE
Dr. Adam Brownstein, MD
Family Medicine Physician · Milton, DE
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across Delaware
Delaware's healthcare costs run approximately 11% above the national average, reflecting the state's proximity to high-cost metropolitan markets like Philadelphia and Washington, D.C. The First State's small size creates unique market dynamics where provider consolidation and limited competition influence Primary Care Doctor (Family Medicine) visit pricing.
Urban vs. Rural Provider Availability
Northern Delaware's urban corridor from Wilmington to Newark maintains higher provider density and more competitive pricing, while southern Delaware's beach communities and rural areas face greater access challenges. Sussex County patients often travel longer distances for specialized family medicine care, which can impact both convenience and cost. The state's three-county structure creates distinct healthcare markets with varying overhead expenses.
Facility Type and Overhead Costs
ChristianaCare's dominance in northern Delaware and Bayhealth's presence in central and southern regions create different cost structures for hospital-affiliated Primary Care Doctor (Family Medicine) practices. Independent family medicine offices typically offer lower visit costs but may have less comprehensive on-site diagnostic capabilities. Academic medical centers affiliated with Jefferson Health or University of Delaware often charge premium rates for specialized expertise.
Insurance Market Competition in Delaware
Delaware's insurance landscape dominated by Highmark, Aetna, and UHC creates moderate competition that influences negotiated rates with Primary Care Doctor (Family Medicine) providers. The state's small market size means fewer insurance options compared to neighboring states, potentially limiting patients' ability to find lower-cost coverage. Employer-sponsored plans often have better negotiated rates than individual market policies due to larger risk pools.
Physician Supply and Demand in Delaware
With only 4 active Primary Care Doctor (Family Medicine) providers across the entire state, Delaware faces a significant shortage relative to its population of nearly one million residents. This limited supply creates upward pressure on visit costs and can result in longer wait times for appointments. The shortage particularly affects rural areas where patients may need to travel to Wilmington or Dover for specialized family medicine care.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Delaware.
Follow-up, low complexity
Follow-up, moderate complexity
Follow-up, high complexity
New patient, low complexity
New patient, moderate complexity
New patient, high complexity
Costs shown are median negotiated rates. Your actual cost depends on your insurance plan and provider.
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.
Frequently Asked Questions — Primary Care Doctor (Family Medicine) Costs in Delaware
What is the average cost of a Primary Care Doctor (Family Medicine) visit in Delaware without insurance?
Does Delaware Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in Delaware?
What is the difference in cost between an initial consultation and a follow-up visit?
Can I use an HSA or FSA to pay for a Primary Care Doctor (Family Medicine) visit in Delaware?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in Delaware?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 99214)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Nebraska Range: $91 – $314 | $215 |
| 2 | New Hampshire Range: $101 – $282 | $198 |
| 3 | Iowa Range: $80 – $314 | $187 |
| 4 | Maine Range: $80 – $255 | $180 |
| 5 | Minnesota Range: $81 – $313 | $162 |
| 6 | Wisconsin Range: $73 – $313 | $161 |
| 7 | California Range: $70 – $250 | $154 |
| 8 | Wyoming Range: $80 – $251 | $152 |
| 9 | Illinois Range: $77 – $226 | $148 |
| 10 | Massachusetts Range: $80 – $271 | $144 |
| 11 | Rhode Island Range: $85 – $200 | $143 |
| 12 | North Dakota Range: $91 – $240 | $141 |
| 13 | Texas Range: $70 – $221 | $139 |
| 14 | New Mexico Range: $80 – $178 | $138 |
| 15 | Vermont Range: $107 – $166 | $138 |
| 16 | Mississippi Range: $67 – $249 | $136 |
| 17 | Michigan Range: $66 – $249 | $134 |
| 18 | South Dakota Range: $77 – $239 | $132 |
| 19 | Hawaii Range: $70 – $239 | $131 |
| 20 | New York Range: $78 – $200 | $131 |
| 21 | Pennsylvania Range: $73 – $228 | $130 |
| 22 | Louisiana Range: $69 – $222 | $130 |
| 23 | Colorado Range: $80 – $210 | $126 |
| 24 | Connecticut Range: $80 – $200 | $124 |
| 25 | Oregon Range: $80 – $204 | $124 |
| 26 | Indiana Range: $80 – $202 | $123 |
| 27 | Ohio Range: $70 – $201 | $122 |
| 28 | Georgia Range: $72 – $188 | $122 |
| 29 | South Carolina Range: $68 – $216 | $121 |
| 30 | Washington Range: $80 – $202 | $121 |
| 31 | North Carolina Range: $66 – $210 | $119 |
| 32 | Nevada Range: $48 – $182 | $118 |
| 33 | Virginia Range: $60 – $191 | $116 |
| 34 | Arkansas Range: $70 – $175 | $116 |
| 35 | West Virginia Range: $80 – $133 | $115 |
| 36 | Florida Range: $54 – $200 | $115 |
| 37 | Idaho Range: $75 – $179 | $115 |
| 38 | New Jersey Range: $53 – $188 | $113 |
| 39 | Missouri Range: $67 – $148 | $113 |
| 40 | Kansas Range: $76 – $158 | $113 |
| 41 | Maryland Range: $49 – $194 | $112 |
| 42 | District of Columbia Range: $53 – $199 | $112 |
| 43 | Kentucky Range: $80 – $170 | $110 |
| 44 | Utah Range: $60 – $180 | $110 |
| 45 | Tennessee Range: $70 – $168 | $109 |
| 46 | Oklahoma Range: $70 – $158 | $104 |
| 47 | Arizona Range: $63 – $168 | $104 |
| 48 | Alabama Range: $61 – $160 | $100 |
| 49 | Delaware Range: $58 – $123 | $91 |
| 50 | Alaska Range: $80 – $80 | $80 |
| 51 | Montana Range: $80 – $80 | $80 |