Cost of a Primary Care Doctor (Family Medicine) Visit
in Wisconsin
Reviewed by Momentary Medical Group West PC
Wisconsin's healthcare system operates across both urban centers and rural farming communities, with Medicaid expansion coverage serving over 240,000 low-income adults throughout the state. Primary Care Doctor (Family Medicine) visits typically cost patients between $73 and $313, with a median out-of-pocket expense of $98 according to insurer negotiated rate data. The state maintains 1353 active Primary Care Doctor (Family Medicine) providers serving patients from Milwaukee and Madison to smaller agricultural communities, allowing most residents to browse all providers in Wisconsin within reasonable driving distance.
Average
$161
Median
$98
Lowest
$73
Highest
$313
Providers
1,353
25% above national average
Compare Similar Procedures
How does family medicine visit compare to related procedures in Wisconsin?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Internal Medicine Visit Standard office visit with an internist | 99214 | $73 | $98 | $315 | 955 |
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 Wisconsin
Dr. John Nielsen, MD
Family Medicine Physician · Marinette, WI
Dr. Brandi Strong, MD
Family Medicine Physician · Onalaska, WI
Dr. Thomas Willett, DO
Family Medicine Physician · Green Lake, WI
Dr. Scott Escher, MD
Family Medicine Physician · La Crosse, WI
Dr. Kimberly Lansing, MD
Family Medicine Physician · La Crosse, WI
Why Primary Care Doctor (Family Medicine) Visit Costs Vary Across Wisconsin
Wisconsin's healthcare costs run approximately 1% above the national average, reflecting the state's mixed urban-rural economy and moderate competition among health insurers and provider systems. The state's geography creates distinct cost patterns between metropolitan areas like Milwaukee-Madison and agricultural regions requiring longer travel distances for specialty care.
Urban vs. Rural Provider Availability
Wisconsin's Primary Care Doctor (Family Medicine) providers concentrate heavily in the Milwaukee and Madison metropolitan areas, while rural counties often rely on regional medical centers or require patients to travel significant distances. This geographic disparity creates higher costs in rural areas due to limited provider competition and increased overhead for practices serving dispersed populations across farming communities.
Facility Type and Overhead Costs
Hospital-based outpatient clinics typically charge facility fees in addition to physician charges, making Primary Care Doctor (Family Medicine) visits more expensive than independent practice visits. Wisconsin's major health systems like UW Health, Froedtert, and Marshfield Clinic operate extensive networks that often command higher negotiated rates with insurance companies compared to smaller independent practices.
Insurance Market Competition in Wisconsin
The state maintains moderate insurer competition with BCBS Wisconsin (Anthem), UnitedHealthcare, and WEA Trust serving as dominant players alongside several smaller regional plans. This competitive environment helps keep Primary Care Doctor (Family Medicine) costs relatively stable, though rural areas may have fewer plan options and less negotiating power between insurers and local providers.
Physician Supply and Demand in Wisconsin
Wisconsin's 1353 active Primary Care Doctor (Family Medicine) providers create adequate supply in urban areas but potential shortages in rural counties, particularly in northern and western regions of the state. This geographic imbalance contributes to longer wait times and potentially higher costs in underserved areas, while metropolitan regions maintain more competitive pricing due to greater provider density.
Cost by Procedure Type
Family Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Wisconsin.
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 Wisconsin
What is the average cost of a Primary Care Doctor (Family Medicine) visit in Wisconsin without insurance?
Does Wisconsin Medicaid cover Primary Care Doctor (Family Medicine) visits?
How do I find an affordable Primary Care Doctor (Family Medicine) near me in Wisconsin?
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 Wisconsin?
How does telemedicine affect the cost of seeing a Primary Care Doctor (Family Medicine) in Wisconsin?
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 |