Most people believe that private medicine is only for the ultra wealthy. When they think of hiring a private doctor they often assume their only options are the ultra premium doctors charging $40,000 per person per year.
While this is a real corner of the market, the majority of private medicine doctors are far more affordable.
According to NextMD's study of over 6,500 private medical physicians the average cost per month for direct primary care is roughly $100. This is the total out of pocket costs for the private doctor, but in many cases the patient may actually end up saving money over a year.
Let us break down what it really ends up costing over a year, including cases where it is not the better deal. DPC is an added cost on top of health insurance, not a replacement. You still need insurance for specialists, imaging, hospitalizations, surgeries, and most prescriptions. Numbers below use NextMD's April 2026 database of 4,650+ concierge and DPC practices and 6,500+ verified MD or DO physicians.[6] See our concierge vs direct primary care comparison for the broader model view.
Quick Facts
DPC costs average about $1,200 per year (about the same as a gym membership)
Having a private doctor reduces ER visits by 41%. This is the largest potential savings by using DPC from a strict money standpoint
DPC doctors usually have 600 or fewer patients, so far more personalized attention than standard primary care with up to 2,500 patients
You often get direct access to your DPC doctor via cell phone and 24/7 access
What Traditional Primary Care Actually Costs
Under an employer-sponsored insurance plan (PPO or similar), the typical adult pays:[1]
Premium (employee share): about $1,400 per year for individual coverage.
Deductible: roughly $1,800 per year, reset every January. You pay out of pocket until you hit it.
Primary care copays: usually $20 to $50 per visit. A year with 3 to 4 visits runs $60 to $200.
Labs: billed through insurance. An annual panel (CBC + CMP) costs about $100 at retail pricing.[2]
ER visit if needed: averages $2,200. On a PPO, this hits your deductible first.[3]
What DPC Costs
The fee distribution across NextMD's 1,106 DPC practices with published pricing:[5][6]
National average: $100 per month ($1,200 per year)
Middle 50% of practices: $75 to $125 per month
Range: $50 to $200 per month (above $200, it is usually concierge, not DPC)
Children: around $40 per month; families: $150 to $300 total
New York metro median: $150 per month, about 50% above the national average.[5]
What the $100 per month membership typically includes (no per-visit fee at 89% of DPC practices):[4] same-day appointments, unlimited visits, phone and text access to your doctor, telemedicine, nutritional counseling, weight management, EKG, basic procedures, and in-house labs at 50 to 90% off retail.
Lab Cost Comparison
Lab pricing is the clearest place DPC saves. From Hint Health's 2025 data:[2]
Lab Test | DPC Cost | National Average | Savings |
|---|---|---|---|
Prostate Specific Antigen (PSA) | $9.50 | $36.00 | 74% |
Complete Blood Count (CBC) | $18.53 | $50.00 | 63% |
Comprehensive Metabolic Panel (CMP) | $3.31 | $48.00 | 93% |
Pap Smear | $17.99 | $37.00 | 52% |
DPC practices bypass insurance billing entirely. An annual CBC plus CMP panel costs about $100 through insurance and $20 through a DPC practice.
The HDHP Question
Should you switch to a high-deductible health plan (HDHP) and use DPC for primary care?
HDHPs have lower premiums (about $1,000 per year individual, vs $1,400 for a PPO) and higher deductibles. For 2026, IRS minimums are $1,650 individual and $3,300 family; real-world averages run around $2,700 individual.[1] You trade lower monthly cost for higher out-of-pocket risk.
DPC does not reduce your HDHP deductible. DPC covers primary care. It does not cover an ER visit, specialist consult, MRI, surgery, or hospitalization. If any of those happen, you pay out of pocket up to the deductible regardless of DPC.
For healthy adults confident they rarely need care beyond primary care, HDHP plus DPC can work. Otherwise the HDHP deductible is real exposure DPC does not cover.
Cost Comparison: Two Scenarios
These tables hold the insurance plan constant (a traditional PPO) and add DPC as the only variable. Numbers are rounded. Assume: one adult, 3 to 4 PCP visits per year, one annual lab panel.
Scenario A: Healthy year, no ER visit
Cost Category | PPO Only | PPO + DPC |
|---|---|---|
Health insurance premium[1] | $1,400 | $1,400 |
DPC membership[5][6] | $0 | $1,200 |
PCP visit copays (3 to 4 visits) | $150 | $0 (included) |
Annual lab panel[2] | $100 | $20 |
Total for the year | $1,650 | $2,620 |
DPC costs about $1,000 more in a healthy year. That gap is what you pay for same-day access, longer visits, and the lab discount.
Scenario B: Year where DPC helps you avoid one ER visit
On average, DPC patients go to the ER 40.51% less than matched traditional-insurance patients.[4] This will not happen every year for every person, but over time, even one avoided ER visit pays for the membership.
Cost Category | PPO Only (has one ER visit) | PPO + DPC (ER visit avoided) |
|---|---|---|
Health insurance premium[1] | $1,400 | $1,400 |
DPC membership[5][6] | $0 | $1,200 |
PCP visit copays (3 to 4 visits) | $150 | $0 (included) |
Annual lab panel[2] | $100 | $20 |
ER visit out of pocket[3] | ~$2,200 | $0 (issue resolved by your DPC doctor) |
Total for the year | $3,850 | $2,620 |
DPC saves about $830 in a year where it prevents one ER visit. The $1,000 gap from Scenario A flips into $830 in savings the moment DPC does what the population data says it does on average.
Why DPC Reduces ER Visits
The Society of Actuaries found DPC patients had 40.51% fewer ER visits, 52.50% lower ER-related costs, and 12.64% lower total healthcare costs on a risk-adjusted basis.[4] The mechanism is direct: when you can text your doctor at 9pm or get a same-day visit, most reasons people end up in the ER for non-emergencies disappear. Hint Health data covering 1.2 million DPC members shows they average 3.5x more physician visits per year than fee-for-service patients, and that upstream access is what drives the ER number down.[2] These are population-level averages, not individual guarantees.
Who Benefits Most, and Who Does Not
DPC most likely pays for itself if you manage a chronic condition (diabetes, hypertension, heart disease), see primary care 5+ times per year, or live in a lower-cost market where DPC clusters under $100 per month.
DPC is less likely to save money if you are healthy and rarely see a doctor, your employer already offers low-copay primary care, or you live in a high-cost market (NYC DPC median: $150 per month). See our State of Concierge Medicine 2026 data report for the national view.
It is worth noting that DPC is not just about financial savings but you also get substantially better access to your primary doctor than with a traditional primary care physician.
HSA Compatibility (New as of 2026)
As of January 1, 2026, DPC membership fees are HSA-eligible for HDHP enrollees.[2] Paying a $1,200 DPC membership with pre-tax HSA dollars cuts the after-tax cost by roughly 25% to 35%, depending on your tax bracket.
The Bottom Line
DPC usually costs about $1,000 per year on top of health insurance. In any single year, it rarely saves money outright. What it buys is access, time, and better primary care, and for patients with higher ER use or chronic disease, the population-level ER reduction often repays the premium.
If you value same-day appointments and direct access, compare practices near you at nextmd.ai/search.
Sources
Kaiser Family Foundation. (2024). Employer Health Benefits Survey. Referenced for average employee premium contributions and deductible data.
Hint Health. (2025). Employer Trends in Direct Primary Care. Based on data from 2,400+ clinicians and 1.2M members. Referenced for lab pricing comparison, real estate firm case study, and HSA compatibility. hint.com
Robinson-Walker, D. Concierge Medicine. Forbes Health. Referenced for 24-day wait time and ER cost data.
Busch, F., Grzeskowiak, D., & Huth, E. (2020). Direct Primary Care: Evaluating a New Model of Delivery and Financing. Society of Actuaries / Milliman. Referenced for DPC fee survey, services included, claims cost comparison, and ER utilization data. soa.org
NextMD. (2026). City-Aggregates: New York Metro (April 2026 refresh). Pricing by model derived from the 4,650-practice NextMD census refreshed 2026-04-19. Referenced for NYC metro DPC and concierge pricing medians.
NextMD. (2026). The State of Concierge Medicine 2026: Data From 4,650 Practices and 6,500 Physicians. nextmd.ai/blog/state-of-concierge-medicine-2026