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South Carolina

Cost of a Primary Care Doctor (Family Medicine) Visit
in South Carolina

Reviewed by Momentary Medical Group West PC

South Carolina ranks as the most affordable state in the nation for Primary Care Doctor (Family Medicine) visits, with costs running 26% below the national average despite serving rural communities across 46 counties. Patients typically pay between $68 and $216, with a median out-of-pocket cost of $80 according to insurer negotiated rate data. With 107 active Primary Care Doctor (Family Medicine) providers across the state, patients can browse all providers in South Carolina to find care that fits their budget and location.

Average

$121

Median

$80

Lowest

$68

Highest

$216

Providers

107

National avg: $129South Carolina: $121

6% below national average

Compare Similar Procedures

How does family medicine visit compare to related procedures in South Carolina?

ProcedureCPTLowMedianHighProviders
Internal Medicine Visit

Standard office visit with an internist

99214$73$80$163109

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 99214Office/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 South Carolina

Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across South Carolina

South Carolina's healthcare costs run approximately 1% below the national average, reflecting the state's lower cost of living and competitive provider market across both metropolitan areas like Charleston and Columbia and smaller rural communities. The state's moderate healthcare market growth and expanding ambulatory surgery center presence help contain costs while maintaining access across diverse geographic regions.

Urban vs. Rural Provider Availability

South Carolina's Primary Care Doctor (Family Medicine) providers concentrate heavily in the Charleston, Columbia, and Greenville metropolitan areas, leaving many rural counties with limited access and requiring patients to travel significant distances for care. Rural providers often charge less due to lower overhead costs and community economic conditions, while urban practices face higher real estate, staffing, and operational expenses. The state's coastal geography creates additional access challenges, with some barrier island and remote inland communities relying on telehealth or traveling over an hour to reach family medicine providers.

Facility Type and Overhead Costs

Hospital-owned outpatient clinics affiliated with major health systems like MUSC Health, Prisma Health, and AnMed Health typically charge higher rates due to facility fees and corporate overhead structures. Independent family medicine practices often offer lower base rates and more flexibility in pricing, especially for self-pay patients or those seeking direct primary care arrangements. Academic medical centers connected to the University of South Carolina or other medical training programs may have different cost structures that reflect their teaching mission.

Insurance Market Competition in South Carolina

The state's insurance market features moderate competition among major carriers including BCBS SC, UHC, and Aetna, with BlueCross BlueShield of South Carolina maintaining the largest market share and strongest provider networks. Limited insurer competition in rural areas can result in higher premiums and more restrictive networks, affecting which Primary Care Doctor (Family Medicine) providers patients can access affordably. The state's decision not to expand Medicaid has created a coverage gap that impacts provider payment mix and pricing strategies.

Physician Supply and Demand in South Carolina

With 107 active Primary Care Doctor (Family Medicine) providers serving over 5.1 million residents, South Carolina maintains adequate but not abundant primary care capacity, particularly in rural areas where physician recruitment remains challenging. This moderate provider supply helps maintain competitive pricing while avoiding severe shortages that could drive costs significantly higher. Growing population centers like Charleston and Greenville continue attracting new physicians, while rural areas face ongoing challenges recruiting and retaining family medicine providers.

Cost by Procedure Type

Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in South Carolina.

CPT 99213107 providers

Follow-up, low complexity

$80
Range: $44$155
CPT 99214107 providers

Follow-up, moderate complexity

$80
Range: $68$216
CPT 9921598 providers

Follow-up, high complexity

$108
Range: $80$317
CPT 99203104 providers

New patient, low complexity

$88
Range: $66$197
CPT 99204100 providers

New patient, moderate complexity

$111
Range: $80$296
CPT 9920598 providers

New patient, high complexity

$156
Range: $80$392

Costs shown are median negotiated rates. Your actual cost depends on your insurance plan and provider.

JP

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.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — Primary Care Doctor (Family Medicine) Costs in South Carolina

What is the average cost of a Primary Care Doctor (Family Medicine) visit in South Carolina without insurance?

Uninsured patients in South Carolina pay between $68 and $216 for Primary Care Doctor (Family Medicine) visits, with a median cost of $80 based on insurer negotiated rates. New patient visits range from $88 to $156 median depending on complexity, while established patient follow-ups typically cost $80 to $108. Many providers offer cash-pay discounts that can reduce these amounts by 10-30% for patients who pay at the time of service.

Does South Carolina Medicaid cover Primary Care Doctor (Family Medicine) visits?

South Carolina Medicaid covers Primary Care Doctor (Family Medicine) visits for eligible beneficiaries, though the state has not expanded Medicaid and maintains strict income requirements. Coverage is limited to pregnant women, children, elderly, and disabled individuals who meet federal poverty guidelines. Many low-income adults who don't qualify for traditional Medicaid rely on federally qualified health centers and community clinics for affordable family medicine care.

How do I find an affordable Primary Care Doctor (Family Medicine) near me in South Carolina?

Compare costs across different types of providers, as independent practices often charge less than hospital-owned clinics in South Carolina. Look for federally qualified health centers and community health centers that offer sliding fee scales based on income, particularly in underserved rural areas. Many providers offer cash-pay discounts for uninsured patients, and some participate in direct primary care models that provide unlimited visits for a monthly membership fee.

What is the difference in cost between an initial consultation and a follow-up visit?

New patient visits with a Primary Care Doctor (Family Medicine) in South Carolina cost $88 to $156 median depending on complexity, while established patient follow-up visits range from $80 to $108 median. Initial consultations typically take more time for comprehensive health history and physical examination, resulting in higher charges. The complexity of your medical condition and the amount of time spent with the provider determine which billing code and corresponding cost applies to your visit.

Can I use an HSA or FSA to pay for a Primary Care Doctor (Family Medicine) visit in South Carolina?

Yes, Primary Care Doctor (Family Medicine) visits qualify as eligible medical expenses for both Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA). You can use these pre-tax dollars to pay for copays, deductibles, and coinsurance associated with your family medicine visits. Keep receipts for your records, as you may need to provide documentation if your account administrator requests verification of eligible expenses.

How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in South Carolina?

Telemedicine visits with Primary Care Doctor (Family Medicine) providers in South Carolina typically cost 10-20% less than in-person visits and became widely covered by insurance during the COVID-19 pandemic. Many providers continue offering virtual consultations for routine follow-ups, medication management, and minor acute conditions. However, some insurers have returned to pre-pandemic telehealth coverage policies, so check with your plan about virtual visit benefits and whether copays differ from in-person care.

Click a state to compare costs

Average Visit Cost

$80
$215

Office visit (CPT 99214)

Compare With Other States

RankStateAverage
1Nebraska
Range: $91$314
$215
2New Hampshire
Range: $101$282
$198
3Iowa
Range: $80$314
$187
4Maine
Range: $80$255
$180
5Minnesota
Range: $81$313
$162
6Wisconsin
Range: $73$313
$161
7California
Range: $70$250
$154
8Wyoming
Range: $80$251
$152
9Illinois
Range: $77$226
$148
10Massachusetts
Range: $80$271
$144
11Rhode Island
Range: $85$200
$143
12North Dakota
Range: $91$240
$141
13Texas
Range: $70$221
$139
14New Mexico
Range: $80$178
$138
15Vermont
Range: $107$166
$138
16Mississippi
Range: $67$249
$136
17Michigan
Range: $66$249
$134
18South Dakota
Range: $77$239
$132
19Hawaii
Range: $70$239
$131
20New York
Range: $78$200
$131
21Pennsylvania
Range: $73$228
$130
22Louisiana
Range: $69$222
$130
23Colorado
Range: $80$210
$126
24Connecticut
Range: $80$200
$124
25Oregon
Range: $80$204
$124
26Indiana
Range: $80$202
$123
27Ohio
Range: $70$201
$122
28Georgia
Range: $72$188
$122
29South Carolina
Range: $68$216
$121
30Washington
Range: $80$202
$121
31North Carolina
Range: $66$210
$119
32Nevada
Range: $48$182
$118
33Virginia
Range: $60$191
$116
34Arkansas
Range: $70$175
$116
35West Virginia
Range: $80$133
$115
36Florida
Range: $54$200
$115
37Idaho
Range: $75$179
$115
38New Jersey
Range: $53$188
$113
39Missouri
Range: $67$148
$113
40Kansas
Range: $76$158
$113
41Maryland
Range: $49$194
$112
42District of Columbia
Range: $53$199
$112
43Kentucky
Range: $80$170
$110
44Utah
Range: $60$180
$110
45Tennessee
Range: $70$168
$109
46Oklahoma
Range: $70$158
$104
47Arizona
Range: $63$168
$104
48Alabama
Range: $61$160
$100
49Delaware
Range: $58$123
$91
50Alaska
Range: $80$80
$80
51Montana
Range: $80$80
$80
Family Medicine Visit in Other States