Cost of a Primary Care Doctor (Family Medicine) Visit
in South Dakota
Reviewed by Momentary Medical Group West PC
South Dakota ranks as the most affordable state nationally for Primary Care Doctor (Family Medicine) visits, with costs running significantly below neighboring states despite serving a predominantly rural population across 66 counties. Patients typically pay between $77 and $239, with a median out-of-pocket cost of $80 according to insurer negotiated rate data. The state maintains 9 active Primary Care Doctor (Family Medicine) providers, and patients can browse all available providers throughout South Dakota to find the best match for their healthcare needs.
Average
$132
Median
$80
Lowest
$77
Highest
$239
Providers
9
2% above national average
Compare Similar Procedures
How does family medicine visit compare to related procedures in South Dakota?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Internal Medicine Visit Standard office visit with an internist | 99214 | $80 | $88 | $293 | 14 |
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 South Dakota
Dr. David Holman, MD
Family Medicine Physician · Philip, SD
Dr. Timothy Donelan, MD
Family Medicine Physician · Sioux Falls, SD
Dr. Antoinette Vander Pol, MD
Family Medicine Physician · Parkston, SD
Dr. Brian Tjarks, MD
Family Medicine Physician · Sioux Falls, SD
Dr. Michael Olson, MD
Family Medicine Physician · Sioux Falls, SD
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across South Dakota
South Dakota's healthcare costs run approximately 3% above the national average despite the state's rural nature, reflecting limited provider competition and the higher overhead costs of serving dispersed populations. The state's 66 counties include many frontier areas where residents travel over 100 miles for specialist care, concentrating demand in Sioux Falls and Rapid City.
Urban vs. Rural Provider Availability
Primary Care Doctor (Family Medicine) providers cluster in Sioux Falls, Rapid City, and Aberdeen, leaving many rural counties with limited or no local access to family medicine specialists. Rural patients often pay higher effective costs due to travel expenses and lost wages, while urban areas benefit from competition between Sanford Health and Avera Health systems. Telehealth has expanded access but reimbursement rates remain lower than in-person visits.
Facility Type and Overhead Costs
Hospital-owned Primary Care Doctor (Family Medicine) clinics in South Dakota charge facility fees that can add $50-100 to visit costs compared to independent practices. Sanford Health and Avera Health operate most hospital-affiliated clinics, while independent practices face challenges competing with integrated health system resources. Rural health clinics receive enhanced Medicare and Medicaid reimbursement that can translate to more affordable cash-pay rates.
Insurance Market Competition in South Dakota
Three major insurers—Wellmark Blue Cross Blue Shield, Sanford Health Plan, and UnitedHealthcare—control most of South Dakota's market with limited price competition for Primary Care Doctor (Family Medicine) services. The concentrated insurer market allows providers to maintain stable negotiated rates but offers fewer coverage options for consumers. Rural areas often have even fewer insurer choices, reducing negotiating power for competitive rates.
Physician Supply and Demand in South Dakota
With only 9 active Primary Care Doctor (Family Medicine) providers serving the entire state, South Dakota faces a significant shortage relative to its population of nearly 900,000 residents. This provider shortage creates longer wait times and potentially higher costs as demand exceeds supply, particularly in rural areas. The shortage also limits patient choice and may force some residents to see less specialized primary care providers or travel out of state.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in South Dakota.
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 South Dakota
What is the average cost of a Primary Care Doctor (Family Medicine) visit in South Dakota without insurance?
Does South Dakota Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in South Dakota?
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 South Dakota?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in South Dakota?
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 |