Cost of a Primary Care Doctor (Family Medicine) Visit
in Kentucky
Reviewed by Momentary Medical Group West PC
Kentucky's healthcare market benefits from one of the most affordable Primary Care Doctor (Family Medicine) networks in the nation, ranking #1 out of 51 states for cost-effectiveness. Patients typically pay between $80 and $170 for a visit, with a median out-of-pocket cost of $80, reflecting negotiated rates that run approximately 5% below national averages. With 104 active Primary Care Doctor (Family Medicine) providers across the Commonwealth, patients can browse all available providers in Kentucky to find the most cost-effective care option for their needs.
Average
$110
Median
$80
Lowest
$80
Highest
$170
Providers
104
15% below national average
Compare Similar Procedures
How does family medicine visit compare to related procedures in Kentucky?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Internal Medicine Visit Standard office visit with an internist | 99214 | $80 | $85 | $201 | 106 |
| Cardiologist Visit Standard office visit with a cardiologist | 99214 | $79 | $80 | $170 | 15 |
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 Kentucky
Dr. Joseph Gerhardstein, MD
Family Medicine Physician · Lexington, KY
Dr. Brian Smith, MD
Family Medicine Physician · Georgetown, KY
Dr. Herbert Long, MD
Family Medicine Physician · Irvine, KY
Dr. Terri Telle, MD
Family Medicine Physician · Paducah, KY
Dr. James Elliott, MD
Family Medicine Physician · Hardinsburg, KY
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across Kentucky
Kentucky's healthcare costs run approximately 5% below national averages, reflecting lower overhead costs and moderate provider competition across the Commonwealth. The state's mix of urban centers like Louisville and Lexington alongside extensive rural counties creates diverse pricing patterns for Primary Care Doctor (Family Medicine) services.
Urban vs. Rural Provider Availability
Louisville and Lexington concentrate the majority of Kentucky's Primary Care Doctor (Family Medicine) providers, while rural counties in Appalachian regions face provider shortages that can drive up costs. The urban-rural divide means city residents typically have more pricing options, while rural patients may travel significant distances but sometimes find lower overhead costs at smaller practices.
Facility Type and Overhead Costs
Kentucky's healthcare landscape includes major systems like Norton Healthcare, Baptist Health, and UK HealthCare, whose hospital-based Primary Care Doctor (Family Medicine) clinics often charge facility fees. Independent practices typically offer lower base rates, with the $80 median reflecting Kentucky's strong network of community-based family medicine physicians.
Insurance Market Competition in Kentucky
Anthem, UHC, and Humana maintain strong market presence in Kentucky, creating moderate competition that helps control Primary Care Doctor (Family Medicine) reimbursement rates. The state's insurance market concentration allows these major carriers to negotiate competitive rates with provider networks, contributing to Kentucky's cost advantage over neighboring states.
Physician Supply and Demand in Kentucky
With 104 active Primary Care Doctor (Family Medicine) providers serving Kentucky's 4.5 million residents, the state maintains adequate physician supply in urban areas but faces shortages in rural regions. This supply-demand balance keeps costs moderate in cities while potentially increasing access challenges and costs in underserved rural counties.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Kentucky.
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 Kentucky
What is the average cost of a Primary Care Doctor (Family Medicine) visit in Kentucky without insurance?
Does Kentucky Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in Kentucky?
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 Kentucky?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in Kentucky?
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 |