Cost of a Primary Care Doctor (Family Medicine) Visit
in Virginia
Reviewed by Momentary Medical Group West PC
Virginia's healthcare market operates under Medicaid expansion while serving patients across diverse geographic regions from urban Northern Virginia to rural Appalachian counties. Primary Care Doctor (Family Medicine) visits typically cost patients between $60 and $191, with a median out-of-pocket cost of $98 based on insurer negotiated rates. With 264 active Primary Care Doctor (Family Medicine) providers statewide, patients can browse all available providers to find care that fits their budget and location needs.
Average
$116
Median
$98
Lowest
$60
Highest
$191
Providers
264
10% below national average
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 Virginia
Dr. Catherine Pipan, MD
Family Medicine Physician · Fairfax, VA
Dr. Stephen Rex, MD
Family Medicine Physician · Alexandria, VA
Dr. James Winegar, MD
Family Medicine Physician · Duffield, VA
Dr. Paul Buckman, MD
Family Medicine Physician · Nathalie, VA
Dr. Rex Ruiz, MD
Family Medicine Physician · Centreville, VA
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across Virginia
Virginia's healthcare costs run approximately 3% above national averages, influenced by the state's mix of high-income Northern Virginia suburbs and lower-cost rural regions extending into Appalachian counties. This geographic diversity creates significant cost variations within the state, with urban areas commanding premium pricing while rural regions struggle with provider shortages affecting access and competition.
Urban vs. Rural Provider Availability
Northern Virginia's proximity to Washington DC creates a concentrated, high-cost market with numerous specialists and hospital systems, while rural Southwest Virginia and the Shenandoah Valley face provider shortages that limit patient choice. The Hampton Roads region around Norfolk and Virginia Beach maintains moderate pricing due to military healthcare facilities and regional competition, while Richmond benefits from academic medical centers balancing costs through resident physicians and community programs.
Facility Type and Overhead Costs
Hospital-owned practices affiliated with systems like VCU Health, UVA Health, and Sentara typically charge facility fees that increase total visit costs compared to independent family medicine offices. Virginia's growing number of urgent care centers and retail clinics provides lower-cost alternatives for routine family medicine needs, particularly in suburban areas where real estate and staffing costs remain manageable.
Insurance Market Competition in Virginia
Anthem Blue Cross Blue Shield dominates Virginia's individual market while competing with Optima Health and UnitedHealthcare in employer-sponsored coverage, creating moderate negotiated rate competition. Rural areas often have limited insurer choices, reducing competitive pressure on provider reimbursement rates, while Northern Virginia's federal employee concentration brings additional insurers and pricing transparency through government contracting requirements.
Physician Supply and Demand in Virginia
Virginia's 264 active Primary Care Doctor (Family Medicine) providers create adequate coverage in urban areas but leave gaps in rural counties designated as Health Professional Shortage Areas. Strong medical schools at VCU and UVA help train physicians, though many graduates migrate to higher-paying specialties or out-of-state positions, creating ongoing primary care recruitment challenges that support stable to increasing pricing for family medicine services.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Virginia.
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 Virginia
What is the average cost of a Primary Care Doctor (Family Medicine) visit in Virginia without insurance?
Does Virginia Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in Virginia?
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 Virginia?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in Virginia?
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 |