Cost of a Primary Care Doctor (Family Medicine) Visit
in West Virginia
Reviewed by Momentary Medical Group West PC
West Virginia's healthcare system confronts unique challenges with one of the nation's highest rates of preventable chronic conditions, requiring robust primary care infrastructure across mountainous terrain and rural communities. Primary Care Doctor (Family Medicine) visits in the state typically cost patients between $80 and $133, with a median out-of-pocket expense of $133 according to insurer negotiated rate data. With 180 active Primary Care Doctor (Family Medicine) providers serving the Mountain State, patients can browse all available providers to find affordable care options within their communities.
Average
$115
Median
$133
Lowest
$80
Highest
$133
Providers
180
11% below national average
Compare Similar Procedures
How does family medicine visit compare to related procedures in West Virginia?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Internal Medicine Visit Standard office visit with an internist | 99214 | $80 | $133 | $159 | 127 |
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 West Virginia
Dr. Douglas Midcap, DO
Family Medicine Physician · Wheeling, WV
Dr. Kim Stooke, MD
Family Medicine Physician · Vienna, WV
Dr. Robert Olexo, DO
Family Medicine Physician · Rainelle, WV
Dr. Sharileda Vance, MD
Family Medicine Physician · Vienna, WV
Dr. Brian Macaulay, MD
Family Medicine Physician · Charleston, WV
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across West Virginia
West Virginia's healthcare costs run approximately 2% below the national average despite significant geographic and infrastructure challenges that affect healthcare delivery across 55 counties. The state's mountainous terrain and rural population distribution create unique cost pressures that influence Primary Care Doctor (Family Medicine) pricing throughout different regions.
Urban vs. Rural Provider Availability
Charleston, Morgantown, and Huntington concentrate most Primary Care Doctor (Family Medicine) specialists, creating competitive pricing in these metropolitan areas while rural counties face provider shortages that can drive up costs. Remote Appalachian communities often require patients to travel significant distances for specialty care, sometimes affecting local provider pricing due to limited competition.
Facility Type and Overhead Costs
Hospital-based outpatient clinics affiliated with major health systems like Charleston Area Medical Center, WVU Medicine, and Cabell Huntington Hospital typically charge higher facility fees compared to independent Primary Care Doctor (Family Medicine) practices. These overhead differences significantly impact total visit costs, with hospital-owned clinics sometimes charging double the rates of independent family medicine practices.
Insurance Market Competition in West Virginia
Limited insurer competition with Highmark West Virginia, UnitedHealthcare, and Aetna dominating the market reduces negotiating pressure that might otherwise lower Primary Care Doctor (Family Medicine) costs. Rural counties often have only one or two insurer options, limiting patients' ability to shop for better coverage terms and potentially affecting provider reimbursement rates.
Physician Supply and Demand in West Virginia
With 180 active Primary Care Doctor (Family Medicine) providers serving a population of 1.8 million, West Virginia maintains adequate specialist availability in urban centers but faces shortages in rural areas. This uneven distribution creates pricing disparities where rural patients may pay premium rates for limited local options or travel to urban centers for more competitive pricing.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in West 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 West Virginia
What is the average cost of a Primary Care Doctor (Family Medicine) visit in West Virginia without insurance?
Does West Virginia Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in West 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 West Virginia?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in West 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 |