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Infant Wellness Visit, New Patient

Delaware rates for HCPCS 99381

This is a comprehensive preventive checkup for an infant under one year old who is new to the practice, including a physical exam, growth check, and guidance for parents on feeding, development, and safety. It is a routine wellness visit rather than a visit for a specific illness.

Rates data updated October 2026.

How much does Infant Wellness Visit, New Patient cost?

$87.10

Typical physician fee. In Delaware, October 2026.

Insurers have agreed to pay about $87.10 for this service. Most negotiated rates run $66.07 to $97.72.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $89 · 10th to 90th $66 to $95Professionalmedian $87 · 10th to 90th $56 to $115
$50$100$200facility $89professional $87

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$66.07
Median
$66.07
Typical High
$95.50
Aetna
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$93.33
Typical High
$112.20
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$32.36
Median
$39.81
Typical High
$48.98
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$9.77
Median
$12.02
Typical High
$14.45
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.46
Median
$7.94
Typical High
$9.77
Cigna
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Cigna
Setting
Professional
Modifier
None
Typical Low
$56.23
Median
$91.20
Typical High
$109.65
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$190.55
Typical High
$208.93
United
Setting
Professional
Modifier
None
Typical Low
$53.70
Median
$79.43
Typical High
$114.82
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Highmark BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$134.90
Median
$173.78
Typical High
$234.42

Where Delaware sits

The same service costs 2.9 times more in Alaska than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Delaware· 43rd of 51

$87.10

AK $204DC $70.79

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.