Cost of a General Doctor (Adult) Visit
in Illinois
Reviewed by Momentary Medical Group West PC
Illinois ranks 46th out of 51 states for General Doctor (Adult) visit costs, with pricing concentrated 10% above the national average despite Medicaid expansion coverage. Patients typically pay between $73 and $226, with a median out-of-pocket cost of $155 for established patient visits across the state's 2,018 active General Doctor (Adult) providers. Browse all internal medicine providers in Illinois to compare costs and find the most affordable option for your specific insurance plan.
Average
$151
Median
$155
Lowest
$73
Highest
$226
Providers
2,018
15% above national average
Compare Similar Procedures
How does internal medicine visit compare to related procedures in Illinois?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Family Medicine Visit Standard office visit with a family medicine physician | 99214 | $77 | $141 | $226 | 1,158 |
| Cardiologist Visit Standard office visit with a cardiologist | 99214 | $70 | $155 | $226 | 263 |
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 internal 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 Internists in Illinois
Dr. Saritha Vankana, MD
Internal Medicine Physician · Maywood, IL
Dr. Dean Gravlin, MD
Internal Medicine Physician · Peoria, IL
Dr. Prasanna Kumar, MD
Internal Medicine Physician · Granite City, IL
Dr. Wa'El Abdo, MD
Internal Medicine Physician · Lisle, IL
Dr. Cory Chen, MD
Internal Medicine Physician · Chicago, IL
Why General Doctor (Adult) Visit Costs Vary Across Illinois
Illinois healthcare costs run approximately 10% above the national average, influenced by the state's concentration of academic medical centers in Chicago and limited specialist availability in rural downstate communities. The dominance of large health systems and higher-than-average commercial insurance reimbursement rates contribute to elevated pricing compared to neighboring Midwest states.
Urban vs. Rural Provider Availability
The Chicago metropolitan area contains nearly two-thirds of Illinois's General Doctor (Adult) providers, creating significant access disparities for residents of rural counties in southern and western Illinois. Downstate communities often rely on family medicine physicians for internal medicine needs, while Chicago-area patients benefit from subspecialty-trained internists at major academic centers. Travel costs and time off work compound the expense burden for rural patients seeking specialized internal medicine care in urban centers.
Facility Type and Overhead Costs
Hospital-owned practices affiliated with systems like Advocate Health Care, OSF HealthCare, or Presence Health typically charge facility fees that can increase visit costs by 40-60% compared to independent physician practices. Chicago's concentration of academic medical centers including Northwestern, University of Chicago, and Rush drives higher baseline pricing due to teaching hospital overhead and research costs. Independent internal medicine groups, particularly in suburban markets, often offer more competitive pricing without facility fee surcharges.
Insurance Market Competition in Illinois
Blue Cross Blue Shield of Illinois maintains the largest market share, followed by UnitedHealthcare and Aetna, creating moderate competition that prevents the most aggressive rate negotiations seen in highly competitive markets. The state's insurance market concentration allows major health systems to negotiate higher reimbursement rates, which are reflected in patient cost-sharing obligations. Limited insurer competition in rural Illinois counties can result in narrow provider networks and higher out-of-pocket costs for patients seeking in-network internal medicine care.
Physician Supply and Demand in Illinois
With 2,018 active General Doctor (Adult) providers statewide, Illinois maintains adequate specialist supply in urban areas but faces shortages in rural regions where patients may wait 4-6 weeks for non-urgent appointments. The concentration of providers in the Chicago area creates competitive pricing pressure in suburban markets, while limited supply downstate allows providers to maintain higher fee schedules. Physician recruitment challenges in rural Illinois are compounded by lower Medicaid reimbursement rates and limited commercial insurance penetration outside metropolitan areas.
Cost by Procedure Type
Internal Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Illinois.
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 — General Doctor (Adult) Costs in Illinois
What is the average cost of a General Doctor (Adult) visit in Illinois without insurance?
Does Illinois Medicaid cover General Doctor (Adult) visits?
How do I find an affordable General Doctor (Adult) near me in Illinois?
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 General Doctor (Adult) visit in Illinois?
How does telemedicine affect the cost of seeing a General Doctor (Adult) in Illinois?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 99214)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Nebraska Range: $80 – $314 | $236 |
| 2 | New Hampshire Range: $113 – $282 | $205 |
| 3 | Maine Range: $85 – $255 | $197 |
| 4 | Wyoming Range: $98 – $303 | $177 |
| 5 | Iowa Range: $80 – $274 | $165 |
| 6 | Wisconsin Range: $73 – $315 | $162 |
| 7 | Minnesota Range: $73 – $313 | $159 |
| 8 | Vermont Range: $73 – $243 | $158 |
| 9 | New Mexico Range: $80 – $234 | $157 |
| 10 | South Dakota Range: $80 – $293 | $154 |
| 11 | Illinois Range: $73 – $226 | $151 |
| 12 | District of Columbia Range: $59 – $242 | $148 |
| 13 | Delaware Range: $80 – $200 | $141 |
| 14 | Massachusetts Range: $80 – $255 | $140 |
| 15 | California Range: $80 – $250 | $138 |
| 16 | New York Range: $73 – $200 | $135 |
| 17 | Washington Range: $80 – $242 | $134 |
| 18 | Michigan Range: $66 – $236 | $130 |
| 19 | Hawaii Range: $70 – $228 | $128 |
| 20 | Georgia Range: $74 – $202 | $127 |
| 21 | Connecticut Range: $80 – $202 | $125 |
| 22 | Arkansas Range: $72 – $175 | $125 |
| 23 | Indiana Range: $74 – $209 | $125 |
| 24 | Louisiana Range: $70 – $202 | $124 |
| 25 | Colorado Range: $80 – $203 | $124 |
| 26 | West Virginia Range: $80 – $159 | $124 |
| 27 | Oregon Range: $80 – $206 | $124 |
| 28 | Ohio Range: $70 – $201 | $124 |
| 29 | Rhode Island Range: $80 – $200 | $123 |
| 30 | Pennsylvania Range: $74 – $202 | $122 |
| 31 | Kentucky Range: $80 – $201 | $122 |
| 32 | Utah Range: $75 – $204 | $121 |
| 33 | North Dakota Range: $80 – $188 | $120 |
| 34 | North Carolina Range: $73 – $200 | $119 |
| 35 | Florida Range: $55 – $207 | $117 |
| 36 | Tennessee Range: $73 – $173 | $115 |
| 37 | Missouri Range: $72 – $146 | $115 |
| 38 | Maryland Range: $49 – $202 | $112 |
| 39 | Nevada Range: $48 – $202 | $112 |
| 40 | Kansas Range: $72 – $151 | $111 |
| 41 | Arizona Range: $65 – $179 | $111 |
| 42 | South Carolina Range: $73 – $163 | $105 |
| 43 | Oklahoma Range: $72 – $158 | $105 |
| 44 | New Jersey Range: $53 – $193 | $103 |
| 45 | Alabama Range: $64 – $160 | $101 |
| 46 | Mississippi Range: $64 – $150 | $101 |
| 47 | Idaho Range: $75 – $125 | $93 |
| 48 | Montana Range: $80 – $102 | $87 |
| 49 | Alaska Range: $80 – $91 | $84 |