Cost of a Primary Care Doctor (Family Medicine) Visit
in Illinois
Reviewed by Momentary Medical Group West PC
Illinois ranks #45 out of 51 states for Primary Care Doctor (Family Medicine) visit costs, with negotiated insurance rates approximately 10% above the national average despite having 1158 active providers statewide. Patients typically pay between $77 and $226 for a visit, with a median out-of-pocket cost of $141. The state's concentrated healthcare market, centered heavily around the Chicago metropolitan area, creates distinct cost patterns from urban Cook County to rural downstate communities.
Average
$148
Median
$141
Lowest
$77
Highest
$226
Providers
1,158
15% above national average
Compare Similar Procedures
How does family medicine visit compare to related procedures in Illinois?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Internal Medicine Visit Standard office visit with an internist | 99214 | $73 | $155 | $226 | 2,018 |
| Cardiologist Visit Standard office visit with a cardiologist | 99214 | $70 | $155 | $226 | 263 |
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 Illinois
Dr. Matthew Brown, MD
Family Medicine Physician · Chicago, IL
Dr. Bradford Wainer, DO
Family Medicine Physician · Berwyn, IL
Dr. Daniel Smith, MD
Family Medicine Physician · Decatur, IL
Dr. Dawn Bode, MD
Family Medicine Physician · Moline, IL
Dr. James Clancy, MD
Family Medicine Physician · Chicago, IL
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across Illinois
Illinois maintains Primary Care Doctor (Family Medicine) costs approximately 10% above the national average, driven by the state's concentration of healthcare resources in the Chicago metropolitan area and varying provider density across its diverse geographic regions. The Prairie State's healthcare market reflects distinct urban-rural dynamics, from densely packed Chicago medical districts to underserved rural counties in southern Illinois.
Urban vs. Rural Provider Availability
Chicago and its suburbs account for the majority of Illinois's 1158 Primary Care Doctor (Family Medicine) providers, creating competitive pricing in Cook and collar counties while leaving rural areas like southern Illinois with limited specialist access. This geographic concentration drives higher costs in urban markets but longer travel distances and limited options in agricultural regions downstate.
Facility Type and Overhead Costs
Major health systems like Northwestern Medicine, Rush University Medical Center, and Advocate Aurora Health operate extensive networks of hospital-affiliated Primary Care Doctor (Family Medicine) clinics throughout Illinois, typically charging higher facility fees than independent practices. Community health centers and federally qualified health centers provide more affordable options, particularly in underserved areas of Chicago and rural Illinois counties.
Insurance Market Competition in Illinois
The state's insurance market features moderate competition between Blue Cross Blue Shield of Illinois, UnitedHealthcare, and Aetna, with regional players like Health Alliance serving central Illinois markets. This competitive landscape helps moderate negotiated rates compared to single-insurer rural markets, though Chicago's dominance still drives statewide costs above neighboring states like Indiana and Missouri.
Physician Supply and Demand in Illinois
Illinois's 1158 active Primary Care Doctor (Family Medicine) providers create adequate supply in metropolitan areas but significant shortages in rural counties, particularly in the state's agricultural southern regions. This uneven distribution contributes to higher costs in underserved areas where patients may travel substantial distances for specialty care, while Chicago's physician density supports more competitive pricing structures.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Illinois.
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 Illinois
What is the average cost of a Primary Care Doctor (Family Medicine) visit in Illinois without insurance?
Does Illinois Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in Illinois?
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 Illinois?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in Illinois?
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 |