Cost of a Primary Care Doctor (Family Medicine) Visit
in Vermont
Reviewed by Momentary Medical Group West PC
Vermont's rural geography concentrates healthcare delivery within a few regional hubs, leaving many residents traveling significant distances for specialty care despite the state's Medicaid expansion coverage. Primary Care Doctor (Family Medicine) visits in Vermont typically cost patients between $107 and $166, with a median out-of-pocket cost of $140 according to insurer negotiated rate data. With just 33 active Primary Care Doctor (Family Medicine) providers serving the entire state, patients benefit from comparing costs and checking insurance coverage before scheduling appointments.
Average
$138
Median
$140
Lowest
$107
Highest
$166
Providers
33
7% above national average
Compare Similar Procedures
How does family medicine visit compare to related procedures in Vermont?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Internal Medicine Visit Standard office visit with an internist | 99214 | $73 | $157 | $243 | 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 Vermont
Dr. Julie Davis, MD
Family Medicine Physician · White River Junction, VT
Dr. David Coddaire, MD
Family Medicine Physician · Morrisville, VT
Dr. Jeffery Allyn, MD
Family Medicine Physician · Randolph, VT
Dr. Peter Loescher, MD
Family Medicine Physician · Sharon, VT
Dr. Thomas Evans, MD
Family Medicine Physician · Brattleboro, VT
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across Vermont
Vermont's healthcare costs run approximately 15% above national averages despite serving a predominantly rural population, reflecting the state's limited provider supply and high practice overhead costs. The concentration of specialty care around Burlington creates access challenges for residents in remote counties, often requiring travel times exceeding 90 minutes for specialist appointments.
Urban vs. Rural Provider Availability
Burlington's Chittenden County contains nearly half of Vermont's Primary Care Doctor (Family Medicine) providers, while rural counties like Essex and Grand Isle have limited or no local specialists. This geographic disparity forces rural patients to travel to regional centers, often increasing total visit costs when factoring in transportation and time off work.
Facility Type and Overhead Costs
Hospital-owned practices affiliated with systems like UVM Medical Center or Southwestern Vermont Medical Center typically charge higher rates due to facility fees and administrative overhead. Independent Primary Care Doctor (Family Medicine) practices maintain lower operating costs but face challenges competing with hospital systems for insurance contracts and referral relationships.
Insurance Market Competition in Vermont
BCBS Vermont and MVP Health Care dominate the state's insurance market, limiting competitive pressure on negotiated rates with Primary Care Doctor (Family Medicine) providers. This concentrated market structure allows insurers to maintain stronger negotiating positions, though Vermont's regulatory environment provides some consumer protections against excessive rate increases.
Physician Supply and Demand in Vermont
With only 33 active Primary Care Doctor (Family Medicine) providers serving Vermont's 645,000 residents, the state faces a moderate specialist shortage that contributes to longer wait times and higher costs. Rural practice challenges including lower reimbursement rates, limited support staff, and professional isolation make physician recruitment difficult outside major population centers.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Vermont.
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 Vermont
What is the average cost of a Primary Care Doctor (Family Medicine) visit in Vermont without insurance?
Does Vermont Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in Vermont?
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 Vermont?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in Vermont?
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 |