FAA Medical Exam Cost: What Affects Price and How to Compare AMEs

The FAA does not set the price for an aviation medical exam. Each Aviation Medical Examiner (AME) runs a private practice and sets their own fee. That means two pilots in the same city can pay very different amounts for the same class of certificate. This post explains what drives the price and how to compare AMEs before you book.

The FAA Does Not Set the Fee

This is the first thing to understand. The FAA designates AMEs and sets the medical standards. It does not set what they charge. The fee is a business decision made by each doctor's office.

Because of that, you will see a wide range of prices in search results and forum posts. Some pilots report paying around $100. Others report $200 or more. A first class exam in a large city may cost more than a third class exam in a smaller town. These numbers come from pilot reports and clinic listings, not from an official FAA price list. Treat any number you see online as a rough guide only.

The only reliable price is the one the office quotes you. Call and ask before you book.

What Usually Affects the Price

Several things tend to move the fee up or down. Ask about each one when you call.

Class of certificate

A first class exam often costs more than a second or third class exam. First class exams can involve more steps, such as an ECG for older pilots. More steps mean more time and often a higher fee. For a plain breakdown of what each class requires, see FAA medical classes explained.

Extra tests and paperwork

Some visits need more than the basic exam. Examples include:

• An ECG, which many first class exams for pilots age 35 and over require, then each year after age 40.
• Vision testing beyond the standard check.
• Review of records for a past condition.
• Paperwork for a Special Issuance or a condition the AME can issue on the spot.

Each of these can add to the bill. Ask whether the quoted price includes them or not.

Location and demand

AMEs in big cities with high overhead often charge more. So do busy offices with long wait lists. Rural areas may be cheaper, but you may have to drive farther. If you live in a large state, it helps to compare several offices. You can start with our lists for Aviation Medical Examiners in California, Aviation Medical Examiners in Texas, or Aviation Medical Examiners in Florida.

How the office runs

Some offices block out more time per pilot. Some do exams only on certain days. Some charge a separate fee for the certificate paperwork. None of this is wrong. It is just worth knowing before you compare two quotes.

What the Price Does Not Cover

The exam fee is only one part of your cost. Keep these in mind:

• Travel. You may need to drive to another town for an AME with an opening.
• Time off. A deferral can stretch your timeline by weeks or months. That can affect work or training schedules.
• Follow-up visits. If the AME needs more information, you may pay for another visit or for records.
• Insurance. Many health plans do not cover an FAA exam, because it is not routine care. Check with your plan and the AME office before you assume it is covered.

How to Compare AMEs

Price matters, but it is not the only thing. Use this checklist when you call around.

1. Confirm the class you need. Say "first class," "second class," or "third class" clearly. Ask for the price for that class.
2. Ask what the fee includes. Does it cover the exam, the certificate, and any standard tests? Are there add-on charges?
3. Ask about extra tests. If you are 35 or older and need a first class exam, ask whether an ECG is included and what it costs.
4. Ask about your medical history. If you have a past condition, ask whether the AME handles it and whether it changes the price or timeline.
5. Ask about scheduling. How soon can you be seen? How long does the visit take?
6. Check the fit. Read reviews and see how the office handles questions. A slightly higher fee from an AME who knows your condition may save you time and stress. Our guide on how we rank AMEs explains what we look at.

You can also use the FAA Designee Locator to confirm an AME is current. Only an FAA-designated AME can issue an FAA medical certificate.

Before You Book: Lower Your Risk of Extra Costs

A clean, complete application lowers the chance of a deferral, and a deferral is where costs and delays really add up.

• Fill out FAA Form 8500-8 in MedXPress before your visit and bring the confirmation number. The application stays valid for 60 days. Answering falsely is a federal offense.
• Gather records for any past condition, surgery, or medication. Bring them to the visit.
• Know the basics. Blood pressure must be 155/95 or lower for all classes. Distant vision must be 20/20 or better in each eye for first and second class, and 20/40 for third class, with or without correction. Near vision must be 20/40 at 16 inches for all classes. You must be able to tell the colors you need for your job.
• If you take medication or have a condition like sleep apnea or a history of ADHD, ask the office in advance how they handle it. Some cases can be issued on the spot. Others need a deferral to the FAA, which can take weeks or months. Our Special Issuance guide explains the process.

If the AME cannot issue, they can deny or defer. A deferral sends your file to the FAA in Oklahoma City or a Regional Flight Surgeon. That review is where timelines stretch. Planning ahead is the best way to avoid surprise costs.

When BasicMed May Cost Less

Some private pilots do not need a current FAA medical certificate at all. BasicMed lets certain pilots fly without one if they meet the rules. You must have held a valid FAA medical certificate at some point after July 14, 2006, take an approved online course every 24 months, and get an exam from any state-licensed physician every 48 months using the FAA checklist. Flights must stay below 18,000 feet MSL, at 250 knots or less, and not for compensation or hire. Aircraft and passenger limits were raised by the FAA Reauthorization Act of 2024, so check the current FAA BasicMed page. For a side by side look, read BasicMed vs third class.

Key takeaways

• The FAA does not set exam fees. Each AME sets their own price, so call and ask for a quote for your class.
• First class exams often cost more than second or third class, partly because of extra steps like an ECG for older pilots.
• Ask what the fee includes, whether extra tests cost more, and whether your health plan covers any of it.
• A complete MedXPress application and your medical records lower the chance of a deferral, which is where time and money add up.
• Compare more than price. An AME who knows your condition can save you weeks. Start with find an AME near you, and check the FAA Guide for Aviation Medical Examiners or ask your AME when rules may change.