How Much Does a Primary Care Visit Cost in 2022?

Primary healthcare should be accessible to everyone, regardless of financial circumstances, age, gender, health insurance, or any other personal factor.

COVID-19 has increased our reliance on our healthcare system, forcing us to take a longer look at accessibility and affordability. 

There are many benefits to primary care.

This article will discuss the factors that contribute to the cost of a primary care visit and how to save money.

What is Primary Care?

Primary care is accessible healthcare provided by a primary care physician (PCP) for general services.

These services typically address a majority of personal healthcare needs.

Primary care is often the first step to addressing healthcare needs.

Your PCP will refer you to a specialist to receive more specific secondary care treatment if necessary. 

Primary care physicians often maintain long-term relationships with patients.

They track your medical history to treat you for a variety of health-related issues. 

Primary care typically includes: 

• Routine physical exams
• Prescribing medication
• Managing chronic health conditions
• Managing acute health conditions
• Screenings
• Treatment of minor illnesses and injuries

Research demonstrates that access to primary care is associated with a variety of positive health outcomes, including:

• A usual source of healthcare – Patients with a usual source of primary healthcare are more likely to receive preventative treatment for acute and chronic disease
• Early detection and treatment of disease
• Management of chronic disease
• Preventative care

The Cost of a Primary Care Visit

The average cost of a primary care visit in the United States without insurance is $171.

The price will increase for any additional services not included in the typical primary care visit, such as immunizations, lab testing, prescriptions, and x-rays. 

Office Visit Cost

According to the cost estimator of Healthcare Blue Book, an online guide to healthcare pricing, the average cost of an office visit for a patient with a level 1 health concern is $68.

Level 1 is a minor problem requiring counseling and treatment, spending approximately 10 minutes with a doctor. 

The average cost of an office visit for a level 5 patient is $234.

Level 5 is a complex medical problem requiring comprehensive care with approximately 40 minutes spent with a doctor. 

The prices of an office visit can vary and are largely dependent on the level of care the patient requires.

Services

Primary care services can include preventative healthcare, health counseling, health education, and diagnosis and treatment of acute and chronic illnesses.

Since primary care physicians often develop long-term relationships with patients, they can better provide tailored health education, recommendations, and support. 

If you’re managing a chronic health condition and need ongoing medical care, having a PCP can help you monitor long-term health conditions and track your medical history to ensure proper care. 

Location

Your location can determine the cost of a primary care visit, and primary care prices can vary even within the same geographical region.

Call around and weigh your options for providers near you to determine which will offer the most affordable price for the type and level of care you require.

Factors that Influence Cost

Remember there are many factors that will impact the cost of a primary care visit, including the following:

Health Insurance, or Lack Thereof 

According to the Current Population Survey Annual Social and Economic Supplement (CPS ASEC) in 2019, 8% of people didn’t have health insurance. 

Without health insurance, the cost of a primary care visit will likely be higher.

But remember that healthcare prices aren’t always fixed.

Often, a primary care provider, emergency room, or urgent care can work with you to set up a payment plan. 

Conditions

Depending on your current health condition and the care you need, prices for primary care can vary.

Average prices for physical examinations can start out low (about $299), but if your primary care visit requires additional tests, the cost can reach $600. 

Physician Location

Just as your location can determine the cost of a primary care visit, so too can the physician’s location.

PCPs typically operate in clinics, long-term care facilities, outpatient/ inpatient hospital settings, and private or group practices. 

Cost Compared to Other Care Types

This chart from debt.org compares the costs of different medical conditions for emergency room and urgent care visits. 

Urgent Care

According to Debt.org, the average urgent care visit costs between $100 and $150 with insurance and up to $400 or $500 without insurance.

Nearly all procedures are covered by insurance, and urgent care centers typically have most of the equipment necessary to treat various health conditions.

The average cost of an urgent care visit is higher than a doctor’s visit but still significantly lower than the average cost of a trip to the emergency room (ER). 

Urgent care visits are popular because of their convenience but often aren’t any more necessary than a visit to your PCP. 

Unlike most doctor’s offices, urgent care centers don’t require appointments and are typically open during the evenings and weekends. 

While the treatments that urgent care can provide are typically not limited, here are some health issues most often addressed by urgent care:

• Ear infections
• Fever or flu symptoms
• Seasonal allergies
• Sprains or broken bones
• Vomiting or diarrhea
• Bronchitis
• Moderate asthma/breathing discomfort
• Urinary tract infections (UTIs)
• Cuts that may require stitches
• X-rays and lab tests
• Minor back pain

If you experience an extreme medical condition, visit a hospital ER where more resources and services are available.

Emergency Room

The average cost of a trip to the emergency room in 2017 was $1,389 according to a study by Healthcare Cost Institute. 

ER visits are typically the most expensive care option. Hospital emergency room visits tend to be pricier because ERs have overhead costs that doctors’ offices and urgent care centers don’t.

These costs include nurses and doctors who specialize in emergency care and trauma and quick access to many types of lab equipment. 

As of January 1, 2021, the Hospital Price Transparency Rule now states that every hospital in the United States is required to provide clear information online regarding the services the hospital provides.

The rule also says that hospitals must provide at least 300 “shopable services” that a patient can schedule in advance. 

Emergency rooms are the best option for handling severe health issues such as:

• Chest pain (which could be a sign of a heart attack or stroke)
• Compound fracture 
• Severe burns
• Concussion/loss of consciousness
• Poisoning
• Severe asthma attack
• Abdominal pain
• Head injury or persistent headaches
• Difficulty breathing/shortness of breath
• Paralysis
• Vaginal bleeding with pregnancy

Direct Primary Care

Another type of healthcare that may be more economically beneficial is direct primary care.

Direct primary care aims to establish a relationship between the patient and provider, including a fixed monthly payment covering specific primary care specialties. 

This option could reduce healthcare costs but may not be worthwhile if you don’t have any health issues that require consistent visits to primary care facilities. 

How to Save Money on Primary Care Visits

• Find a consistent primary healthcare provider. Regular check-ups with a PCP will lower the cost and frequency of future office visits.
• Invest in health insurance. Individuals without health insurance are more likely to delay visiting a healthcare provider when ill or injured. They’re also more likely to be hospitalized for chronic conditions.
• If you’re uninsured or not a member of an accepted insurance company and need to make an appointment for a health concern, you may be able to set up a payment plan with the facility. Depending on the facility, healthcare costs may be able to be split up into multiple payments. 

See a PCP Today, No Insurance Needed

Whether you have insurance or not, you can see a doctor from home with K Health for an affordable price.

Start by checking your symptoms for free, explore conditions and treatments, and if needed, text with a healthcare provider in minutes. Get started now.