Cost of a Primary Care Doctor (Family Medicine) Visit
in Pennsylvania
Reviewed by Momentary Medical Group West PC
Pennsylvania's healthcare market divides between two major metropolitan hubs—Philadelphia and Pittsburgh—which together serve over 40% of the state's population while leaving rural counties with limited provider access. Primary Care Doctor (Family Medicine) visits typically cost between $73 and $228 in Pennsylvania, with most patients paying around $90 out-of-pocket based on insurer negotiated rates. The state maintains 115 active Primary Care Doctor (Family Medicine) providers, allowing patients to browse options across urban centers and rural communities throughout Pennsylvania.
Average
$130
Median
$90
Lowest
$73
Highest
$228
Providers
115
1% above national average
Compare Similar Procedures
How does family medicine visit compare to related procedures in Pennsylvania?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Internal Medicine Visit Standard office visit with an internist | 99214 | $74 | $91 | $202 | 208 |
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 Pennsylvania
Dr. Karla Lowman, MD
Family Medicine Physician · Chambersburg, PA
Dr. Mark Malicki, MD
Family Medicine Physician · Johnstown, PA
Dr. John Brooks, DO
Family Medicine Physician · Clarion, PA
Dr. Joseph Labricciosa, DO
Family Medicine Physician · Broomall, PA
Dr. Michael Hall, MD
Family Medicine Physician · Du Bois, PA
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across Pennsylvania
Pennsylvania's healthcare costs run approximately 9% above the national average, driven by the state's concentration of major academic medical centers and the geographic divide between densely populated southeastern and southwestern regions and sparsely populated rural counties. This urban-rural split creates significant disparities in both provider availability and pricing for Primary Care Doctor (Family Medicine) services.
Urban vs. Rural Provider Availability
Philadelphia and Pittsburgh metropolitan areas contain the majority of Pennsylvania's Primary Care Doctor (Family Medicine) providers, while rural counties in central and northern regions often face provider shortages. This geographic imbalance drives higher costs in underserved areas and longer wait times for appointments outside major metropolitan regions.
Facility Type and Overhead Costs
Hospital-affiliated clinics operated by major health systems like UPMC, Penn Medicine, and Geisinger typically charge higher facility fees than independent Primary Care Doctor (Family Medicine) practices. These health system consolidations have increased overhead costs throughout Pennsylvania, contributing to higher overall pricing compared to smaller, independent medical groups.
Insurance Market Competition in Pennsylvania
Highmark, Independence Blue Cross, and UnitedHealthcare dominate different regions of Pennsylvania, with Highmark stronger in western areas and Independence Blue Cross concentrated in southeastern markets. This regional segmentation limits insurer competition in some areas, affecting negotiated rates and potentially increasing out-of-pocket costs for Primary Care Doctor (Family Medicine) visits.
Physician Supply and Demand in Pennsylvania
With 115 active Primary Care Doctor (Family Medicine) providers serving over 13 million residents, Pennsylvania faces moderate supply constraints that contribute to pricing pressures. The concentration of providers in Philadelphia and Pittsburgh creates competitive pricing in those markets while leaving rural areas with limited options and potentially higher costs due to reduced competition.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Pennsylvania.
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 Pennsylvania
What is the average cost of a Primary Care Doctor (Family Medicine) visit in Pennsylvania without insurance?
Does Pennsylvania Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in Pennsylvania?
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 Pennsylvania?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in Pennsylvania?
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 |