How Much Does a Doctor Visit Cost in 2026?
A doctor visit costs $150–$400 without insurance and $20–$75 with insurance. Costs vary by new vs established patient, PCP vs specialist, and visit complexity. Here’s what to expect.
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Doctor Visit Cost by Type
What you pay depends on whether you’re a new or established patient, the type of doctor, and the complexity of your visit. These are self-pay (uninsured) prices.
| Visit Type | Description | Self-Pay Cost |
|---|---|---|
| PCP — Established patient | Routine follow-up, chronic condition management, simple complaint | $150 – $250 |
| PCP — New patient | First visit, comprehensive history, full physical exam | $200 – $350 |
| Specialist — Established | Follow-up for specific condition (dermatology, cardiology, etc.) | $200 – $350 |
| Specialist — New patient | Initial consultation, often longer and more complex | $250 – $500 |
| Telehealth | Virtual visit for simple issues (cold, rash, refills, follow-ups) | $50 – $100 |
| Annual physical / preventive | Wellness exam, screenings, vaccinations | $150 – $300 (free with insurance) |
Sources: Based on CMS Provider Data, Healthcare Bluebook, and national self-pay pricing databases for 2026.
E/M Codes: How Doctor Visits Are Billed
Doctor visits are billed using Evaluation and Management (E/M) codes. Higher-level codes cost more and reflect more complex medical decision-making. Understanding these codes helps you spot billing errors.
| CPT Code | Level | Complexity | Typical Cost |
|---|---|---|---|
| 99213 | Established, Level 3 | Low complexity — single stable chronic condition or mild acute illness | $100 – $175 |
| 99214 | Established, Level 4 | Moderate complexity — 2+ chronic conditions, new problem requiring workup | $150 – $250 |
| 99215 | Established, Level 5 | High complexity — severe illness, multiple conditions, significant risk | $200 – $350 |
| 99204/99205 | New patient, Level 4/5 | Moderate to high complexity — first visit, comprehensive evaluation | $250 – $400 |
Upcoding alert: One of the most common billing errors is “upcoding” — billing a higher-level E/M code than the visit warranted. If you had a simple 10-minute follow-up but were billed 99215 (high-complexity), request a review. Our bill negotiation service checks for this automatically.
Specialist Visit Costs
Common Specialists (Self-Pay)
- • Dermatologist: $150–$300
- • Cardiologist: $200–$400
- • Orthopedist: $200–$400
- • ENT: $175–$350
- • Gastroenterologist: $200–$400
- • Neurologist: $200–$400
Why Specialists Cost More
- • Additional years of training and expertise
- • Specialized equipment and procedures
- • Longer, more complex visits
- • In-office procedures billed separately
- • Hospital-based specialists add facility fees
- • Higher E/M code levels on average
Telehealth: A Cheaper Alternative
Good for Telehealth
- • Cold/flu symptoms
- • Rashes and skin issues
- • Medication refills
- • Follow-up appointments
- • Mental health visits
- • UTI symptoms
Telehealth Cost Savings
- • Self-pay: $50–$100 (vs $150–$300 in-person)
- • With insurance: often same copay ($20–$40)
- • Some plans: $0 copay for telehealth
- • No travel costs or time off work
- • Often available evenings/weekends
- • Shorter wait times
Doctor Visit: With vs Without Insurance
Without Insurance
- • PCP visit: $150–$250
- • Specialist: $200–$500
- • Labs/tests billed separately
- • Self-pay discounts: 10–30% off
- • Ask about sliding-scale fees
With Insurance
- • PCP copay: $20–$40
- • Specialist copay: $40–$75
- • Annual physical: $0 (ACA preventive care)
- • Labs may apply to deductible
- • Stay in-network for lowest cost
Free preventive care: Under the ACA, annual physicals, screenings, and immunizations are covered at $0 cost-sharing with in-network providers. This includes wellness exams, blood pressure screening, cholesterol testing, and age-appropriate cancer screenings.
How to Save on Doctor Visit Costs
Use Telehealth for Simple Issues
Save $50–$200 by using telehealth for simple conditions like colds, rashes, UTIs, and medication refills. Most issues that don’t require physical examination can be handled virtually.
Ask About Self-Pay and Sliding-Scale Pricing
Many practices offer 10–30% off for cash payment. Community health centers (FQHCs) offer sliding-scale fees based on income. Ask before your visit: “What is your self-pay rate?”
Avoid Hospital-Owned Practices
Hospital-owned physician practices add a “facility fee” of $50–$300+ on top of the physician charge. Independent practices don’t charge this. Ask: “Is there a facility fee for this visit?”
Check Your Bill for Upcoding
Request an itemized bill and verify the E/M code matches your visit complexity. A routine follow-up shouldn’t be billed as a 99215 (high-complexity). Use our bill negotiation service if you find issues.
Frequently Asked Questions
How much does a doctor visit cost without insurance?
How much does a doctor visit cost with insurance?
Is telehealth cheaper than an in-person doctor visit?
Why does a new patient visit cost more?
What extra charges might I get on top of the visit fee?
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