How Much Is A Doctor's Visit Cost With and Without Insurance?

The cost of a doctor's visit varies significantly based on your insurance status, the type of doctor you're seeing, and where you live. Without insurance, expect to pay $150-$600 for a doctor's visit depending on the specialty and services provided. With insurance, costs typically range from $25-$70 for a primary care visit after meeting your deductible, though you'll pay the full negotiated rate (usually $100-$400) until your deductible is met.

What Factors Affect the Cost of a Doctor's Visit?

Several key factors determine what you'll pay at the doctor:

• Type of provider (primary care vs. specialist)
• Your location and local healthcare costs
• New or established patient status
• Tests and procedures performed
• Your insurance coverage and plan details
• In-network vs. out-of-network status
• Complexity of your medical condition

How Much Does a Doctor's Visit Cost Without Insurance?

Without insurance, doctor's visit costs vary by specialty, location, and whether you're a new or established patient. New patients typically pay more because of the comprehensive initial evaluation required. 

If you don't have insurance, having Mira is a great way to save. Mira helps navigate you to the right provider who can help solve your problems at the lowest out of pocket cost possible.

Average Doctor Visit Costs by Specialty (2025)

Important: First-time patients typically pay a "new patient fee" averaging $357 nationwide, as these visits require comprehensive evaluations and take longer than follow-up appointments.

Geographic Price Variation for Doctor Visits

Self-pay costs vary significantly across major U.S. cities. Below are typical price ranges for new patient visits in major metropolitan areas:

What This Means for You: Expect to pay 30-60% more in coastal cities like NYC, SF, and Boston compared to cities like Atlanta, Dallas, and Phoenix. For the most affordable care, consider:

• Comparing prices by calling multiple providers
• Looking at suburban practices that often charge less than city-center locations
• Asking about self-pay discounts (typically 20-40% off standard rates)

Understanding Medical Billing and CPT Codes

When you receive a medical bill, each service has a corresponding code that affects what you're charged. These standardized five-digit codes, called Current Procedural Terminology (CPT) codes, were developed by the American Medical Association and are used by all medical providers.

Common Office Visit CPT Codes

Office visits typically use Evaluation and Management (E/M) codes:

The higher the last digit, the more complex the visit and the higher the cost. For example, a level 3 visit (99213) costs less than a level 5 visit (99215).

What This Means for You: When reviewing medical bills, check that the CPT codes match the services you received. A simple issue should not be coded at the highest complexity level (which costs more).