Cost of a Primary Care Doctor (Family Medicine) Visit
in Rhode Island
Reviewed by Momentary Medical Group West PC
Rhode Island's compact geography concentrates most healthcare delivery within a 30-minute drive of Providence, yet the state maintains only 5 active Primary Care Doctor (Family Medicine) providers serving its entire population of 1.1 million residents. Based on current insurer negotiated rates, patients typically pay between $85 and $200 for a Primary Care Doctor (Family Medicine) visit, with a median out-of-pocket cost of $144. These rates run approximately 13% above national averages, reflecting the state's higher cost structure and limited provider competition across its 39 cities and towns.
Average
$143
Median
$144
Lowest
$85
Highest
$200
Providers
5
11% above national average
Compare Similar Procedures
How does family medicine visit compare to related procedures in Rhode Island?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Internal Medicine Visit Standard office visit with an internist | 99214 | $80 | $88 | $200 | 13 |
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 Rhode Island
Dr. Jamiel Ambrad, MD
Family Medicine Physician · Wakefield, RI
Dr. Pierre Manzo, MD
Family Medicine Physician · East Greenwich, RI
Dr. David Kerzer, DO
Family Medicine Physician · Cranston, RI
Dr. Ellen Hight, MD
Family Medicine Physician · East Greenwich, RI
Dr. Susanna Magee, MD
Family Medicine Physician · Pawtucket, RI
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across Rhode Island
Rhode Island's healthcare costs run approximately 13% above national averages, reflecting the state's high cost of living and concentrated provider market within the smallest state geography. The Ocean State's unique position between the expensive Boston and New York markets creates upward pressure on physician compensation and facility overhead costs.
Urban vs. Rural Provider Availability
Rhode Island's urban concentration around Providence, Warwick, and Newport creates relatively uniform access to Primary Care Doctor (Family Medicine) services across the state's 1,214 square miles. Unlike truly rural states, most Rhode Island residents can reach specialty care within 30 minutes, though the limited provider pool of just 5 active practitioners creates potential scheduling delays. The state's coastal geography and dense population distribution minimize the dramatic cost disparities seen in states with vast rural regions.
Facility Type and Overhead Costs
Hospital-based outpatient clinics affiliated with systems like Lifespan and Care New England typically charge higher facility fees for Primary Care Doctor (Family Medicine) visits compared to independent practices. Rhode Island's high commercial real estate costs and strict zoning regulations in many communities increase overhead expenses for all medical practices. The state's emphasis on quality reporting and electronic health record requirements also adds administrative costs that providers pass through to patients.
Insurance Market Competition in Rhode Island
BCBS RI dominates the state's individual and small group markets, while UHC and Tufts provide additional options primarily through larger employers and Medicare Advantage plans. This concentrated market structure limits competitive pressure on negotiated rates for Primary Care Doctor (Family Medicine) services compared to states with more diverse insurer participation. The state's small population base also reduces insurers' ability to achieve significant economies of scale when contracting with providers.
Physician Supply and Demand in Rhode Island
With only 5 active Primary Care Doctor (Family Medicine) providers serving Rhode Island's population of over one million residents, the state faces a significant shortage that drives up costs and extends wait times for appointments. This limited supply reflects both the challenges of practicing in a high-cost state and competition from nearby Massachusetts and Connecticut markets that may offer better compensation packages. The shortage particularly affects patients seeking same-day or urgent care visits, often forcing them toward more expensive emergency department alternatives.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Rhode Island.
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 Rhode Island
What is the average cost of a Primary Care Doctor (Family Medicine) visit in Rhode Island without insurance?
Does Rhode Island Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in Rhode Island?
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 Rhode Island?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in Rhode Island?
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 |
