Logo
Idaho

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

Reviewed by Momentary Medical Group West PC

Idaho's healthcare system serves a predominantly rural population where 23% of residents live more than 30 minutes from their nearest hospital, creating unique access patterns for primary care services. Patients seeking a Primary Care Doctor (Family Medicine) typically pay between $75 and $179 for their visit, with a median out-of-pocket cost of $90 based on negotiated insurance rates. The state maintains 29 active Primary Care Doctor (Family Medicine) providers to serve Idaho's 1.8 million residents, and patients can browse all available providers throughout Idaho to find the most convenient and affordable option for their healthcare needs.

Average

$115

Median

$90

Lowest

$75

Highest

$179

Providers

29

National avg: $129Idaho: $115

11% below national average

Compare Similar Procedures

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

ProcedureCPTLowMedianHighProviders
Internal Medicine Visit

Standard office visit with an internist

99214$75$80$12519
Cardiologist Visit

Standard office visit with a cardiologist

99214$90$90$1509

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 Idaho

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

Idaho's healthcare costs run approximately 3% below the national average, reflecting the state's lower cost of living and rural market dynamics where provider competition is limited but overhead expenses remain manageable. The state's geography spans from agricultural valleys to mountainous regions, creating distinct cost variations between urban centers like Boise and remote communities that rely on critical access hospitals.

Urban vs. Rural Provider Availability

Boise and Coeur d'Alene concentrate most of Idaho's Primary Care Doctor (Family Medicine) specialists, while rural counties often depend on traveling physicians or telemedicine consultations to supplement local primary care options. This geographic disparity can create higher effective costs for rural patients who must travel long distances or pay premium rates for limited local specialists. Some remote areas rely on nurse practitioners working under physician supervision rather than full-time family medicine physicians.

Facility Type and Overhead Costs

Saint Alphonsus and Saint Luke's health systems operate many hospital-based Primary Care Doctor (Family Medicine) clinics throughout Idaho, which typically charge higher facility fees than independent practices. Independent family medicine practices remain common in Idaho's smaller communities, often offering more competitive cash-pay rates due to lower administrative overhead. Federally qualified health centers serve several rural Idaho communities and typically offer sliding fee scales based on patient income.

Insurance Market Competition in Idaho

Regence BlueCross and PacificSource dominate Idaho's individual and small group insurance markets, creating a moderately competitive environment for negotiated provider rates. The state's insurance market is less concentrated than some neighboring states, allowing for reasonable rate negotiations between insurers and Primary Care Doctor (Family Medicine) providers. Idaho's participation in healthcare sharing ministries and self-funded employer plans also influences the local insurance landscape and provider pricing strategies.

Physician Supply and Demand in Idaho

With 29 active Primary Care Doctor (Family Medicine) providers serving Idaho's 1.8 million residents, the state maintains adequate specialist availability in urban areas but faces shortages in rural regions. This moderate provider supply helps keep costs reasonable in competitive markets like Boise while potentially driving up prices in underserved areas where patients have fewer options. Idaho's medical education programs and recruitment incentives aim to address rural physician shortages, but geographic barriers continue to affect both access and pricing patterns.

Cost by Procedure Type

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

CPT 9921330 providers

Follow-up, low complexity

$87
Range: $75$127
CPT 9921429 providers

Follow-up, moderate complexity

$90
Range: $75$179
CPT 9921517 providers

Follow-up, high complexity

$140
Range: $75$241
CPT 9920329 providers

New patient, low complexity

$90
Range: $75$264
CPT 9920429 providers

New patient, moderate complexity

$95
Range: $75$244
CPT 9920520 providers

New patient, high complexity

$256
Range: $75$706

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 Idaho

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

Without insurance, Primary Care Doctor (Family Medicine) visits in Idaho typically cost between $75 and $179, with a median cost of $90 for a standard follow-up visit. New patient visits tend to be slightly higher, especially for complex consultations. Many providers offer cash-pay discounts that can reduce these rates by 20-40%, and some practices provide sliding fee scales based on income to help uninsured patients access affordable care.

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

Yes, Idaho Medicaid covers Primary Care Doctor (Family Medicine) visits with little to no copayment for eligible members. Idaho expanded Medicaid in 2020, significantly improving access to specialist care for low-income residents who previously couldn't afford these services. Coverage includes both preventive and treatment-focused visits, though patients should verify that their chosen provider accepts Idaho Medicaid before scheduling.

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

Start by comparing costs across different facility types, as independent practices often charge less than hospital-based clinics for the same services. Ask about self-pay discounts if you're uninsured, and consider community health centers that offer sliding fee scales based on income. Momentary Lab can help you compare costs across Idaho providers and check your insurance coverage to find the most affordable option in your area.

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

New patient visits in Idaho typically cost between $75-$264 depending on complexity, while established patient follow-up visits range from $75-$179. The median cost for a new patient visit is around $90-$95, compared to $90 for a standard follow-up appointment. Complex new patient evaluations can cost significantly more, with high-complexity visits reaching up to $706 at some facilities.

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

Yes, Primary Care Doctor (Family Medicine) visits qualify as eligible medical expenses for both Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). This includes both diagnostic visits for specific symptoms and preventive care appointments. Using pre-tax dollars from these accounts can provide significant savings, especially for patients with high-deductible health plans who pay out-of-pocket until reaching their deductible.

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

Telemedicine visits with Primary Care Doctor (Family Medicine) providers in Idaho typically cost 10-30% less than in-person appointments, though exact savings vary by provider and insurance plan. Many Idaho insurers now cover telehealth visits at the same rate as office visits, making them an accessible option for follow-up care and medication management. Rural Idaho residents particularly benefit from telehealth options, which eliminate travel time and costs while maintaining access to specialist care.

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