What common medical visits cost in California – and how they compare to nearby states

smolaw // Shutterstock

What common medical visits cost in California – and how they compare to nearby states

In the patchwork of health care providers in the United States, determining what a medical visit might cost can be confusing at best and life-altering at worst. The vast majority of patients who arrive at the hospital for a service recommended by their doctor do so without knowing the cost of that treatment. The price tag on most medical visits is so high for the uninsured, a full one-third of all money raised on GoFundMe is for health care costs.

A raft of legislation in nearly every state is set on tackling some of these endemic issues, with energy aimed squarely at lowering costs and expanding access. Some of this legislation is grand in scope, notably in states like New York where legislators are looking to put a public option on the table for residents there. Other states are taking a narrower approach, requiring providers to release price lists so patients are aware of what their care will cost.

Stacker analyzed cost data released on June 8, 2021, from the Centers for Medicare & Medicaid Services, common provider data from Verywell Health, and state zip codes from Simplemaps to find the average out-of-pocket cost for three typical medical visits in each state.

California

– Most common family practice visit costs
— Medicare recipients: $114.89 for established patients ($99.50 for new patients)
— Other insurance holders: $28.72 for established patients ($24.88 for new patients)
– Most common internal medicine visit costs
— Medicare recipients: $114.89 for established patients ($147.83 for new patients)
— Other insurance holders: $28.72 for established patients ($36.96 for new patients)
– Most common pediatric medicine visit costs
— Medicare recipients: $114.89 for established patients ($99.50 for new patients)
— Other insurance holders: $28.72 for established patients ($24.88 for new patients)

Health care costs could soon change dramatically for California residents. A current bill is considering a single-payer health system. In such a system, out-of-pocket costs for patients would be outright banned.

Some trends held steady across most states. For family practice and pediatric visits, new patients often pay less than established patients. For internal medicine visits, new patients frequently pay more than established patients. Both of these trends exist regardless of insurance type.

Transparency is increasingly paramount in American health care. Keep reading for a look at what common medical visits cost in neighboring states and the state-level factors that may influence these costs.

Oregon

– Most common family practice visit costs
— Medicare recipients: $100.62 for established patients ($86.82 for new patients)
— Other insurance holders: $25.16 for established patients ($21.71 for new patients)
– Most common internal medicine visit costs
— Medicare recipients: $100.62 for established patients ($129.94 for new patients)
— Other insurance holders: $25.16 for established patients ($32.48 for new patients)
– Most common pediatric medicine visit costs
— Medicare recipients: $100.62 for established patients ($86.82 for new patients)
— Other insurance holders: $25.16 for established patients ($21.71 for new patients)

In 2021, Oregon passed legislation intended to keep health care costs competitive. HB 3262 limits mergers and consolidations between insurers, theoretically making it more likely that a robust network of providers will compete against one another to lower prices.

Arizona

– Most common family practice visit costs
— Medicare recipients: $102.07 for established patients ($88.34 for new patients)
— Other insurance holders: $25.52 for established patients ($22.08 for new patients)
– Most common internal medicine visit costs
— Medicare recipients: $102.07 for established patients ($132.23 for new patients)
— Other insurance holders: $25.52 for established patients ($33.06 for new patients)
– Most common pediatric medicine visit costs
— Medicare recipients: $102.07 for established patients ($88.34 for new patients)
— Other insurance holders: $25.52 for established patients ($22.08 for new patients)

Arizonans looking for cost-saving advocacy from their representatives will need to look further than current Sen. Kyrsten Sinema. The Democrat has vocalized objections to lowering drug prices. Getting rid of this provision—which is currently in national legislation before Congress—could endanger a broader expansion of Medicare coverage.