Cost of a Primary Care Doctor (Family Medicine) Visit
in Massachusetts
Reviewed by Momentary Medical Group West PC
Massachusetts leads the nation with the lowest Primary Care Doctor (Family Medicine) visit costs, ranking #1 out of all 51 states despite having healthcare costs roughly 20% above the national average. Patients typically pay between $80 and $271 for a Primary Care Doctor (Family Medicine) visit, with a median out-of-pocket cost of just $80 across the state's 53 active providers. Browse all Primary Care Doctor (Family Medicine) providers in Massachusetts to find care that fits your budget and location.
Average
$144
Median
$80
Lowest
$80
Highest
$271
Providers
53
12% above national average
Compare Similar Procedures
How does family medicine visit compare to related procedures in Massachusetts?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Internal Medicine Visit Standard office visit with an internist | 99214 | $80 | $85 | $255 | 184 |
| Cardiologist Visit Standard office visit with a cardiologist | 99214 | $80 | $120 | $271 | 24 |
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 Massachusetts
Dr. Jeffrey Palmer, MD
Family Medicine Physician · Greenfield, MA
Dr. Dennis Callen, MD
Family Medicine Physician · Westport, MA
Dr. Henry Simkin, MD
Family Medicine Physician · Florence, MA
Dr. Scott Corkins, MD
Family Medicine Physician · Norwell, MA
Dr. Pamela Grimaldi, DO
Family Medicine Physician · Barre, MA
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across Massachusetts
Massachusetts Primary Care Doctor (Family Medicine) costs run approximately 20% above national averages, driven by the state's high concentration of academic medical centers, elevated cost of living in the Greater Boston area, and a well-educated physician workforce commanding premium rates. The Commonwealth's early adoption of healthcare reform and mandatory insurance coverage has created unique market dynamics that influence both provider supply and pricing structures.
Urban vs. Rural Provider Availability
The Greater Boston metropolitan area concentrates most of Massachusetts's Primary Care Doctor (Family Medicine) providers, while rural areas in Western Massachusetts and Cape Cod face provider shortages that can drive up costs and extend wait times. Urban patients benefit from competition among numerous practices, while rural residents may need to travel significant distances or pay premium rates for limited local options.
Facility Type and Overhead Costs
Hospital-affiliated Primary Care Doctor (Family Medicine) practices, common throughout Massachusetts's major health systems like Mass General Brigham and UMass Memorial, typically charge higher rates due to facility fees and administrative overhead. Independent practices often offer more competitive pricing, though many have been acquired by large health systems in recent years, contributing to market consolidation and standardized pricing.
Insurance Market Competition in Massachusetts
The Massachusetts insurance market features moderate competition among Blue Cross Blue Shield of Massachusetts, Tufts Health Plan, and Harvard Pilgrim, with each negotiating different rates with Primary Care Doctor (Family Medicine) providers. This competitive landscape generally helps moderate costs compared to states with single-insurer dominance, though the state's regulatory environment and mandated benefits add some upward pressure on premiums and reimbursement rates.
Physician Supply and Demand in Massachusetts
With 53 active Primary Care Doctor (Family Medicine) providers serving a population of nearly 7 million residents, Massachusetts faces moderate physician density that varies significantly by region. The state's numerous medical schools produce many family medicine graduates, but competition from specialty training and higher-paying fields can limit primary care supply, particularly affecting rural and underserved urban areas where demand often exceeds availability.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Massachusetts.
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 Massachusetts
What is the average cost of a Primary Care Doctor (Family Medicine) visit in Massachusetts without insurance?
Does Massachusetts Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in Massachusetts?
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 Massachusetts?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in Massachusetts?
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 |