Cost of a General Doctor (Adult) Visit
in Massachusetts
Reviewed by Momentary Medical Group West PC
Massachusetts operates one of the nation's most regulated healthcare markets, with universal coverage requirements that have served as a model for national healthcare reform. General Doctor (Adult) visits across the state range from $80 to $255, with patients typically paying a median out-of-pocket cost of $85 based on negotiated insurance rates. With 184 active General Doctor (Adult) providers throughout Massachusetts, patients can browse comprehensive options from urban academic medical centers to community-based practices.
Average
$140
Median
$85
Lowest
$80
Highest
$255
Providers
184
6% above national average
Compare Similar Procedures
How does internal medicine visit compare to related procedures in Massachusetts?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Family Medicine Visit Standard office visit with a family medicine physician | 99214 | $80 | $80 | $271 | 53 |
| Cardiologist Visit Standard office visit with a cardiologist | 99214 | $80 | $120 | $271 | 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 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 Massachusetts
Dr. Andrea Young, MD
Internal Medicine Physician · Chestnut Hill, MA
Dr. Savita Patil, MD
Internal Medicine Physician · North Billerica, MA
Dr. Margaret Hunt, DO
Internal Medicine Physician · Haverhill, MA
Dr. William Wittman, MD
Internal Medicine Physician · Falmouth, MA
Dr. Richard Brodie, MD
Internal Medicine Physician · Brookline, MA
Why General Doctor (Adult) Visit Costs Vary Across Massachusetts
Massachusetts healthcare costs run approximately 20% above national averages, driven by the state's concentration of prestigious academic medical centers, high cost of living, and sophisticated healthcare infrastructure. The Commonwealth's universal coverage mandate and regulated insurance marketplace create unique pricing dynamics that affect General Doctor (Adult) visit costs throughout the state.
Urban vs. Rural Provider Availability
The greater Boston metropolitan area concentrates the majority of Massachusetts specialists, with world-renowned institutions like Mass General Brigham and Beth Israel Lahey Health driving premium pricing in urban markets. Western Massachusetts and Cape Cod face more limited provider options, though regional health systems like Berkshire Health Systems and Cape Cod Healthcare work to maintain access in these less dense markets. Rural areas often see lower negotiated rates due to reduced competition, but patients may face longer travel times and wait periods.
Facility Type and Overhead Costs
Hospital-owned practices dominate Massachusetts healthcare delivery, with major systems like Mass General Brigham, Beth Israel Lahey Health, and UMass Memorial controlling significant market share and typically charging higher facility fees. Independent General Doctor (Adult) practices often offer lower base costs due to reduced administrative overhead, though many have been acquired by health systems seeking market consolidation. Academic medical centers command premium rates due to their teaching mission, research infrastructure, and subspecialty expertise.
Insurance Market Competition in Massachusetts
The state's insurance landscape features moderate competition between Blue Cross Blue Shield of Massachusetts, Tufts Health Plan, and Harvard Pilgrim Health Care, with each insurer negotiating distinct rate structures with provider networks. Massachusetts's regulated marketplace and standardized benefit requirements limit dramatic pricing variations, though negotiated rates can still differ significantly between insurers and provider systems. The state's emphasis on managed care and accountable care organizations influences how insurers structure their General Doctor (Adult) reimbursement strategies.
Physician Supply and Demand in Massachusetts
With 184 active General Doctor (Adult) providers serving the state's population, Massachusetts maintains relatively strong physician density compared to national averages, particularly in the Boston metropolitan area. The concentration of medical schools including Harvard, Tufts, and UMass ensures steady resident training pipelines, though geographic distribution favors urban centers over rural regions. This adequate supply helps moderate pricing pressure in competitive markets, while shortage areas may see higher rates due to limited provider options.
Cost by Procedure Type
Internal Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Massachusetts.
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 Massachusetts
What is the average cost of a General Doctor (Adult) visit in Massachusetts without insurance?
Does Massachusetts Medicaid cover General Doctor (Adult) visits?
How do I find an affordable General Doctor (Adult) near me in Massachusetts?
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 Massachusetts?
How does telemedicine affect the cost of seeing a General Doctor (Adult) in Massachusetts?
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 |