Price Comparison & Patient Examples
Case 1: The Martínez Family
The Martínez family has two little ones: Sofia, a curious and energetic 6-year-old, and Mateo, their sweet 4-month-old baby. Like many families, they have a solid health insurance plan through work — but it comes with a high deductible. Over the past year, here’s what healthcare looked like for their family:
Sofia (age 6) needed care for:
Her annual well-child checkup (Covered at 100%)
Strep throat (after-hours urgent care) (Average visit cost is $100-$200, plus the cost for additional services like testing, x-rays, labs, or other procedures, which may add anywhere from $50-$250 to the cost of the visit. If you haven't met your deductible (usually a high amount you must pay before the insurance “kicks in”), you're responsible for the full cost of the visit and any additional services. For this particular visit, a family who hasn’t met their yearly deductible will be responsible for the full cost of the visit - on average, $350-400.)
A weird rash on her legs (Another visit, plus the cost of any additional services. When deductible hasn’t been met, the family will be responsible for the full cost of the visit - on average, $250-$350, not including additional labs if indicated or prescriptions.)
A painful bump after a fall (This visit included x-rays. Since the family hasn’t met their yearly deductible ($4500+/year), they are responsible for the full cost of the visit ($450-$650), which includes a radiologist’s interpretation of the x-rays.)
A visit for a camp physical (with no additional testing or abnormal findings: $100-$250)
Mateo (4 months) visited the doctor for:
All routine well visits and vaccinations (Covered at 100%)
Concerns about weight gain ($150-$200 base visit + additional for any testing/workup = around $350-$450 that the family will pay if they haven’t met their deductible.)
Breastfeeding support for Mom with a lactation consultant (may be covered as part of their plan; if not - $75-$300/session.)
A stomach bug with vomiting and diarrhea (Family tried to go to urgent care but they were referred to the Emergency Room for this. Average cost of an ER visit for an urgent, non-like threatening condition is $2100. If other services are needed (IV fluids to prevent dehydration, laboratory tests, and/or imaging) these services are added to the total cost of the visit. The Martinez family was responsible for the full $3275 visit bill.)
Several visits for noisy breathing and congestion (Anywhere from $150-$250 plus other services such as x-rays, nasal swabs to test for various viruses, in-office treatments (nasal suctioning, nebulizer treatments, etc.))
The Martínez family feels incredibly grateful that their kids are generally healthy — but by the end of the year, they’d paid over $4000 out of pocket, despite having “good” insurance. They also spent a lot of time trying to coordinate appointments, taking time off work for appointments, spending time in the Emergency Room for a visit that could have been handled at their doctor’s office, visiting multiple providers who didn’t know their children, juggling nap schedules, and rushing into clinics for things that could have been handled virtually — like sending a photo of that rash or a quick question about feeding.
Case 2: The Johnson Family
The Johnson family recently welcomed their first baby, Zayn — a joyful and squishy bundle of new-parent questions, sleepless nights, and surprises they didn’t see coming.
Like many first-time parents, they’ve had lots of concerns — feeding, sleep, rashes, gas, weight gain — but every checkup with their large pediatric clinic felt rushed. They had to see different doctors at different visits, fill out endless forms, and pay extra just to ask all their questions. They also had no after-hours support and had a hard time getting in for appointments in a timely manner.
Every visit felt overwhelming. And between short appointments and conflicting Google advice, the only way to get reassurance was to drag everyone into the clinic — even when some things could’ve been handled with a quick message, or photo, or video call with the same provider they know and trust, who also knows them, their family, and their new baby well.
On top of doctor bills, they also spent several hundred dollars on a sleep training course online — hoping it would help Zayn sleep more than 90 minutes at a time.
The Johnson family feels fortunate to have a healthy child and good insurance, but as it turns out, they made several doctor visits that cost over $1500 out of pocket. They also spent a lot of time coordinating appointments that could have been handled more simply — like sending a photo of a rash instead of bundling up the baby for another trip to the clinic. If they’d had access to longer, unrushed appointments, they could have had all their answers taken care of at once and the time to deep-dive on specific concerns. Instead, they felt shuffled between different providers who didn’t know their baby well, and they often felt nervous about taking their young baby to a clinic where he could be exposed to other sickness.
At Mercy Grace Pediatrics, there are no extra fees for longer visits, follow-ups, or extra reassurance. Because we limit the number of patients that we see, there is no delay in getting an appointment to see the same provider you know and trust every time. And because we don’t bill insurance, there are no unnecessary forms to fill out at every visit — just care that’s personal, accessible, and built around your family.
Case 3: The Bennett Family
The Bennett family lives just outside of town and has a sweet, curious 9-year-old named Ellie. She’s generally healthy, full of questions, and loves school — but she also lives with asthma, ADHD, and some occasional anxiety around new situations and social settings.
While Ellie doesn’t have major illnesses, her care needs add up over time — med adjustments, asthma management, school forms, check-ins about behavior or sleep. The Bennetts have a high-deductible health plan, which means every visit comes with a bill — and that bill adds up fast. Still, it’s rarely enough to hit their deductible, so it always feels like they’re paying full price just to keep up.
Lately, Ellie’s parents have had growing questions about her focus, emotional outbursts, and how she's adjusting to her new ADHD medication — but at each office visit, they feel rushed and overwhelmed. There’s never quite enough time to ask everything they want to ask, and by the time they leave, they’ve forgotten half the questions they meant to bring up.
With their high-deductible insurance, they’re also paying out of pocket for every appointment, and often hesitate to schedule follow-ups unless absolutely necessary - not because they don’t care, but because they’re trying to be wise with their time and money. They wish they could have more frequent, lower-pressure check-ins — and a provider who knows their daughter and walks with them through the process, including coordinating care and educational supports with her school and any needed specialists.
It’s not Ellie’s fault — or her parents’ — that she needs a little extra support managing chronic conditions. Families shouldn’t be penalized for needing care. That’s why Mercy Grace Pediatrics is a great fit for kids like Ellie: we don’t charge more for things that are out of your control.
Here’s what that looks like in real life:
Chronic care visits are included in your membership — no added fees or copays.
Check-ins happen how and when they’re needed — whether that’s texting, virtual visits, or in-person support.
We stay in direct communication about ongoing concerns — like how Ellie’s doing on her new ADHD medication, or whether her asthma is flaring up again.
If specialty care is needed, we help coordinate referrals and make sure nothing falls through the cracks.
Who Can Benefit from Direct Primary Care?
Direct Primary Care is personalized care built on relationship and access — which makes it a great option for most families.
Our membership model is especially helpful for families who:
Want predictable monthly pricing without surprise bills or copays.
Have high-deductible insurance plans and end up paying out-of-pocket for most visits.
Participate in Health Sharing Ministries that may not cover routine care like checkups or vaccines.
Experience changes in jobs or insurance plans and want the consistency of the same trusted provider.
Prefer longer, unrushed visits where all their questions and concerns are truly heard.
Need quick access to care with easy scheduling and minimal wait times — even for that 9PM cough.
Value direct communication with their pediatric provider instead of impersonal forms or portals.
Appreciate being able to text or email their provider for quick questions and follow-up.
