Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #157 

January 2007 

Regional Differences in Total and Outof-Pocket Expenditures for Selected 

Types of Office-Based Visits, 2004 

Highlights 

 In 2004, for the three common 

types of office-based health 

care visits—general checkup, 

diagnosis or treatment, and 

psychotherapy or mental 

health treatment—the median

total cost and out-of-pocket 

costs were substantially less

than the average costs across

all regions. 

 The average total expenditure 

for a general checkup was 

significantly less in the Northeast than in the Midwest, 

South, and West, and the 

average total expenditure for 

an office visit for diagnosis or

treatment of a condition was 

less in the Northeast than in 

the South.

 The average out-of pocket 

expense for a general checkup was similar in the Midwest 

and South and less in the 

Northeast and West; the 

mean out-of pocket expense

for a visit related to the diagnosis or treatment of a condition was slightly lower in the 

Northeast than in the Midwest, South, or West; and the 

mean out-of pocket expense

for a mental health visit was

lower in the Midwest than the 

Northeast, South, or West. 

 

Erwin Brown, Jr., BS and Karen Beauregard, MHA 

Introduction 

As consumers of U.S. health care become accountable for more of 

their health care costs, they are growing more cognizant of the cost 

and quality of the health care they choose to receive. To date, 

however, little data have been available on the cost of health care 

services to allow consumers to make informed choices when 

purchasing health care. 

Using data from the Household Component of the Medical 

Expenditure Panel Survey (MEPS-HC), this Statistical Brief 

presents overall and regional estimates for the U.S. adult civilian 

noninstitutionalized population on mean and median expenditures 

for three common types of office-based health care visits: general 

checkup, diagnosis or treatment, and psychotherapy or mental 

health treatment. Almost 145 million individuals or two-thirds of all 

adults had one of these three types of physician visits in 2004. 

The estimates shown in this brief are for total and out-of-pocket 

payments. Unless otherwise noted, all differences between estimates discussed in the text are statistically significant at the .05 

level or better. 

Findings 

Overall average and median total expenses (from table 1): 

In 2004, the average total expense for a general checkup for a 

person 18 or older was $133.86. A visit related to diagnosis or

treatment of a medical condition was $155.28, and a mental health

visit was $106.08.

In general, for all three services the median total cost (the cost at which half of the events had payments 

less than or equal to, and half had payments more than) was substantially less than the means

(averages). The averages were substantially larger than the median expenses because a small 

proportion of events had extremely large expenses. 

Regional variations in average total expenses (from table 1): 

The average total expenditure for a general checkup was significantly less in the Northeast ($119.12) 

than in the Midwest, South, and West ($142.13, $139.98, and $132.76, respectively). 
The average total expenditures for an office visit for diagnosis or treatment of a condition were less in the 

Northeast ($139.82) than in the South ($159.79). 

There were no significant differences by region in the average total expense of a mental health visit. 

Overall average and median out-of pocket expenses (from table 2): 

In 2004, the overall average out-of-pocket expense for a general checkup for a person age 18 or older in 

the U.S. was $19.29. A visit related to diagnosis or treatment of a medical condition had a mean out-of 

pocket expense of $22.09, and a mental health visit had an average out-of pocket cost of $30.82. 

Similar to the findings for the total expenses, for all three event types median out-of-pocket expenses 

were significantly less than the means, due to a skewed distribution. 

Regional variations in average out-of pocket expenses (from table 2): 

The average out-of pocket expense for a general checkup was similar in the Midwest and South ($21.01 

and $21.48, respectively) and less in the Northeast and West ($16.06 and $17.50, respectively). 

The mean out-of pocket expense for a visit related to the diagnosis or treatment of a condition was 

slightly lower in the Northeast ($17.06) than in the Midwest, South, or West ($20.88, $23.90, and $25.11, 

respectively). 

The mean out-of pocket expense for a mental health visit was lower in the Midwest than the Northeast, 

South, or West ($13.52 versus $23.09, $36.69, and $47.43, respectively). 

Definitions 

Total expenses/out-of-pocket expenses 

MEPS total expenses include payments from all sources (including third-party payers and other 

miscellaneous sources) to hospitals, physicians, other health care providers (including dental care), and 

pharmacies for services reported by respondents in the MEPS-HC. Out-of-pocket expenses comprise the 

portion of total payments made by individuals and families for services received during the year. 

Census region 

Each MEPS event was classified as being in one of the following four regions as defined by the U.S. 

Census Bureau: 

– Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, 

New Jersey, and Pennsylvania 

– Midwest: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South 

Dakota, Nebraska, and Kansas 

– South: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South 

Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, 

Oklahoma, and Texas 

– West: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, 

California, Alaska, and Hawaii 

Reason for event 

Reason for event was based on a household respondent’s stated reason for visit. This Statistical Brief 

reports expenses for medical office visits that were reported to be for a general checkup, diagnosis or 

treatment of a condition, or psychotherapy or mental health care. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 
For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, sees the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Brown, E., Jr. and Beauregard, K. Regional Differences in Total and Out-of-Pocket Expenditures for 

Selected Types of Office-Based Visits, 2004. Statistical Brief #157. January 2007. Agency for Healthcare 

Research and Quality, Rockville, Md. http://www.meps.ahrq.gov/mepsweb/data_files/publications/ 

st157/stat157.pdf 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Table 1. Mean and median total payments for adults 18+, by selected types of physician office visits and census 

region, 2004 

Type of visit and region Mean of total payment Median of total payment

United States 

General checkup $133.86 $74.99 

Diagnosis or treatment $155.28 $66.48 

Psychotherapy/mental health counseling $106.08 $84.73 

 

Northeast

General checkup $119.12 $71.89 

Diagnosis or treatment $139.82 $61.88 

Psychotherapy/mental health counseling $95.07 $75.68 

Midwest

General checkup $142.13 $76.98 

Diagnosis or treatment $157.16 $61.56 

Psychotherapy/mental health counseling $108.52 $79.26 

South

General checkup $139.98 $72.82 

Diagnosis or treatment $159.79 $73.85 

Psychotherapy/mental health counseling $97.15 $82.90 

 

West

General checkup $132.76 $79.99 

Diagnosis or treatment $160.74 $69.98 

Psychotherapy/mental health counseling $124.89 $94.10 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household component of the Medical Expenditure Panel Survey, 2004 

Table 2. Mean and median out-of-pocket payments for adults 18+, by selected types of physician office visits and 

census region, 2004 

Type of visit and region Mean out-of-pocket payment Median out-of-pocket payment

United States 

General checkup $19.29 $9.73 

Diagnosis or treatment $22.09 $8.98 

Psychotherapy/mental health counseling $30.82 $10.87 

 

Northeast

General checkup $16.06 $9.98 

Diagnosis or treatment $17.06 $8.76 

Psychotherapy/mental health counseling $23.09 $9.55 

Midwest

General checkup $21.01 $9.96 

Diagnosis or treatment $20.88 $7.97 

Psychotherapy/mental health counseling $13.52 $0 

South

General checkup $21.48 $6.35 

Diagnosis or treatment $23.90 $6.21 

Psychotherapy/mental health counseling $36.69 $19.78 

 

West

General checkup $17.50 $9.97 

Diagnosis or treatment $25.11 $9.98 

Psychotherapy/mental health counseling $47.43 $14.49 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household component of the Medical Expenditure Panel Survey, 2004