How much is malpractice insurance? Real filed rates by specialty and state (2026)

Ask what malpractice insurance costs and the honest answer is a question back: for which specialty, and in which state? Published guides skip that part. They quote a national average, maybe a range for surgeons, and move on. The average is the one number no physician actually pays.

Here is what the filed rates show. A psychiatrist's coverage runs about $8,017 a year. An OB/GYN's runs about $59,392. Same country, same year, more than seven times the price. Move that OB/GYN from Wisconsin to Connecticut and the number climbs from roughly $18,456 to $154,590. Geography moves the price more than almost anything else on the quote.

• Cheapest specialty — $8,017 · Psychiatry, national median
• Priciest specialty — $59,392 · OB/GYN, more than 7x psychiatry
• Cheapest state — $3,675 · Wisconsin, median across specialties
• Priciest state — $35,206 · Michigan, about 9.6x Wisconsin

Every figure here comes from carrier rate filings on record with state insurance departments (the SERFF system and state DOIs), normalized to one basis so the numbers compare cleanly: $1M/$3M limits, mature claims-made, manual rate. That is the benchmark carriers file, not a survey, not an estimate, not a marketing range. Across 51 jurisdictions and 19 specialty groups, that is 969 benchmarks built from 1,739 filed carrier rates. Below: the national picture, the two ladders, and how to read your own quote against them.

What malpractice insurance actually costs

Start with the shape of the market, not a single figure. The median specialty in the median state sits in the low five figures a year. The tails run much wider. The cheapest cell in the data, psychiatry in Wisconsin, is filed at about $1,630. The most expensive, OB/GYN in Connecticut, is filed at about $154,590. Those are the low and high manual rates on file, not anecdotes.

That spread is why a national average misleads. The commonly cited "around $7,500 a year" is real as an arithmetic mean, but no working physician is the average of a rural psychiatrist and a metro obstetrician. What you pay is set by two things: your specialty and your state. Get both right and the benchmark shows what carriers have actually filed for someone in your position.

The market backdrop matters too. Malpractice premiums have risen for seven straight years, a run the American Medical Association says it has not seen since 2005, and in 2025 roughly 40% of tracked premiums rose year over year. A quote that looked in-market two years ago may not be now. The filed benchmark is how you check.

Cost by specialty: from psychiatry to OB/GYN

Specialty is the first lever, and it sorts almost entirely by surgical and obstetric risk. Procedural specialties with the highest claim severity sit at the top; office-based, no-surgery specialties sit at the bottom. Top to bottom is about 7.4 times.

The order rarely surprises a physician who knows their risk class, but the size of the steps does. OB/GYN is filed at more than double emergency medicine and more than seven times psychiatry. These are manual rates before any carrier credits or debits, which is why they compare cleanly: everyone is measured at the same starting line.

Cost by state: why geography moves the number more than anything

Now the lever that catches people off guard. Price a single specialty in every state and the range is wider than the range across specialties. General surgery is filed at about $11,286 in Wisconsin and about $118,410 in New Mexico. Same operating physician, same work, roughly 10.5 times the premium, because of where the practice sits. Emergency medicine runs the same pattern: about $6,270 in Wisconsin, about $64,054 in New Jersey, a spread of 10.2 times.

What separates them is not medical but legal and structural: damage caps, the local tort environment, whether the state runs a patient compensation fund, and how many carriers compete there. Wisconsin, at the bottom, pairs a damage cap with a state patient compensation fund; several high-cost states have neither, or have seen large verdicts reset carrier expectations. We break the drivers down in a separate piece on caps, tort reform, and PCF states, and rank all 51 jurisdictions in the state cost ranking.

Your state can matter more than your specialty. A family physician in a high-cost state can pay more than a surgeon in a cheap one.

What "$1M/$3M mature claims-made" means, and why it is the fair comparison

Every number here is stated on one basis, and the basis is what makes the figures comparable at all.

• $1M/$3M — The limits: up to $1 million per claim, $3 million total for the policy year. It is the most common physician limit, so it is the natural benchmark.
• Claims-made — The policy form most physicians carry. It covers a claim only if the policy is active both when the incident happened and when the claim is filed. Because claims often arrive years after the care, a claims-made premium starts low in year one and steps up until it reaches its full, or mature, level, usually around year five. Mature is the apples-to-apples year, so that is what the benchmark uses.
• Manual rate — The filed, pre-credit number. Carriers then apply credits and debits for claims history, part-time status, and territory within the state. The benchmark is the starting point every carrier works from, which is exactly what you want in a yardstick.

Compare a first-year claims-made rate against a mature benchmark and you will think you found a bargain that does not exist. If you are weighing claims-made against occurrence, or pricing the tail you buy when you leave a claims-made policy, those are separate decisions worth understanding before you sign.

How to check your own number, and when a broker can shop it

Put the two levers together and you can sanity-check almost any quote in under a minute. Find your specialty and state on the benchmark, note the filed median, and compare it to your quoted premium, after confirming the quote is stated at the same $1M/$3M mature claims-made basis. If it is a first-year or occurrence number, adjust before you compare. Reading the quote itself has its own guide.

Land near the filed median and you are in market. Land well above and it is worth a conversation, though that alone does not mean the quote is wrong: territory within your state, your claims history, or a thin local carrier market can legitimately move you off the median. The benchmark shows where you stand against what has been filed. It does not tell you what to buy, and it cannot see the specifics of your practice.

That is where a good broker earns their keep. One who works your specialty and state can take your number to the market, see which carriers are competing for your risk right now, and come back with options. The benchmark gives you the number to walk in with; the broker does the shopping.

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Common questions

How much is malpractice insurance for a physician?

It depends almost entirely on specialty and state. Filed medians range from about $8,017 a year for psychiatry to about $59,392 for OB/GYN, on a $1M/$3M mature claims-made basis, and the state can move that by nearly ten times between the cheapest and most expensive.

Why is my quote so different from a colleague's?

Different specialty, different state, or a different basis. A first-year claims-made rate looks far cheaper than a mature one for the same coverage. Confirm both quotes use the same limits and maturity before comparing.

What is the most expensive specialty for malpractice insurance?

OB/GYN (major surgery), at a national median around $59,392, then general surgery near $48,438 and orthopedic surgery near $37,008.

Which states have the highest malpractice premiums?

By median across specialties, Michigan, Illinois, New Jersey, Georgia, and West Virginia top the list; Wisconsin, Nebraska, and Minnesota sit at the bottom.

Sources and method

• Source — Carrier rate filings on record with state insurance departments (SERFF and state DOIs)
• Basis — $1M/$3M limits, mature claims-made, manual (pre-credit) rate; occurrence filings are converted to a claims-made-equivalent mature rate before inclusion
• Coverage — 51 jurisdictions, 19 specialty groups, 969 state-and-specialty cells, built from 1,739 filed carrier rates across 85 filing extracts
• Cell construction — Each cell is the median of the filed carrier rates for that state and specialty; ladders are medians of those cells
• Depth — The median cell rests on two filed carriers and about 10% on three or more; 16 of the 51 jurisdictions currently rest on a single filed carrier across every specialty
• Known limits — Single-carrier states are directionally sound but thinner; treat any single-carrier figure as indicative rather than exact

How we build the filed-rate benchmark

Disclaimer

This article is a market-data benchmarking resource derived from carrier rate filings on record with state insurance departments. It reports filed manual rates for comparison and education. It does not provide, and must not be relied upon as, insurance advice, a coverage recommendation, or a determination that any specific quote is fair or unfair. Healthcare DealHub reports filed data and can refer you to a licensed broker; it does not sell insurance. Your coverage decision is yours to make, with a licensed broker or advisor.