Cost of a General Doctor (Adult) Visit
in Pennsylvania
Reviewed by Momentary Medical Group West PC
Pennsylvania's healthcare market, anchored by major metropolitan centers in Philadelphia and Pittsburgh, creates a diverse cost landscape where patients typically pay between $74 and $202 for General Doctor (Adult) visits, with a median out-of-pocket cost of $91. The state's 208 active General Doctor (Adult) providers serve communities ranging from dense urban areas to rural counties, resulting in significant regional price variations that patients can browse across all Pennsylvania providers.
Average
$122
Median
$91
Lowest
$74
Highest
$202
Providers
208
7% below national average
Compare Similar Procedures
How does internal medicine visit compare to related procedures in Pennsylvania?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Family Medicine Visit Standard office visit with a family medicine physician | 99214 | $73 | $90 | $228 | 115 |
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 Pennsylvania
Dr. Mehul Shah, MD
Internal Medicine Physician · King Of Prussia, PA
Dr. Joseph Rigotti, DO
Internal Medicine Physician · Jenkintown, PA
Dr. Robert Feldman, MD
Internal Medicine Physician · Rockledge, PA
Dr. Joseph Mcallister, MD
Internal Medicine Physician · Abington, PA
Dr. Steven Balint, MD
Internal Medicine Physician · Elkins Park, PA
Why General Doctor (Adult) Visit Costs Vary Across Pennsylvania
Pennsylvania's healthcare costs run approximately 9% above the national average, reflecting the state's concentration of major medical centers in Philadelphia and Pittsburgh combined with rural access challenges across its mountainous and agricultural regions. The state's mature healthcare infrastructure includes world-renowned institutions like Penn Medicine and UPMC, whose market dominance influences pricing throughout their respective regions.
Urban vs. Rural Provider Availability
Pennsylvania's 67 counties span from densely populated southeastern regions around Philadelphia to sparsely populated northern counties where provider shortages drive up costs and reduce competition. Rural areas like Potter and Forest counties often have limited General Doctor (Adult) availability, forcing patients to travel to larger cities like Erie, Scranton, or Williamsport for specialty care. This geographic disparity creates cost premiums in rural markets while urban areas benefit from competitive pricing among multiple health systems.
Facility Type and Overhead Costs
Hospital-owned practices dominate Pennsylvania's healthcare landscape, with health systems like UPMC, Penn Medicine, Geisinger, and Lehigh Valley Health Network acquiring independent physician practices and converting them to higher-cost outpatient departments. These hospital-affiliated clinics typically charge facility fees in addition to physician professional fees, resulting in total visit costs 30-50% higher than independent practices. Academic medical centers in Philadelphia and Pittsburgh command premium pricing due to their teaching hospital status and subspecialty expertise.
Insurance Market Competition in Pennsylvania
Pennsylvania's insurance market splits between eastern regions dominated by Independence Blue Cross and western areas where Highmark holds significant market share, with UnitedHealthcare competing statewide for employer groups. This regional concentration limits insurer competition and can result in higher negotiated rates compared to states with more fragmented markets. The state's lack of a robust individual insurance marketplace further reduces competitive pressure on pricing, particularly in rural counties with limited plan options.
Physician Supply and Demand in Pennsylvania
With 208 active General Doctor (Adult) providers serving over 12.8 million residents, Pennsylvania maintains adequate specialist availability in metropolitan areas but faces shortages in rural regions. The state's physician supply concentrates heavily in the Philadelphia-New York corridor and Pittsburgh metropolitan area, leaving significant gaps in central and northern counties. This uneven distribution creates longer wait times and higher costs in underserved areas while promoting competitive pricing in well-supplied urban markets.
Cost by Procedure Type
Internal Medicine Visit can be billed under different CPT codes depending on what's done during the procedure in Pennsylvania.
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 Pennsylvania
What is the average cost of a General Doctor (Adult) visit in Pennsylvania without insurance?
Does Pennsylvania Medicaid cover General Doctor (Adult) visits?
How do I find an affordable General Doctor (Adult) near me in Pennsylvania?
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 Pennsylvania?
How does telemedicine affect the cost of seeing a General Doctor (Adult) in Pennsylvania?
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 |