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Infant Wellness Visit, New Patient

Vermont 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?

$112

Typical physician fee. In Vermont, October 2026.

Insurers have agreed to pay about $112 for this service. Most negotiated rates run $79.43 to $145.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $112 · 10th to 90th $74 to $191
$100$200professional $112

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$100.00
Typical High
$128.82
BCBS Vermont
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$112.20
Typical High
$125.89
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$131.83
Typical High
$169.82
United
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$117.49
Typical High
$154.88
3 more rates 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
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$36.31
Median
$41.69
Typical High
$56.23
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$10.96
Median
$12.59
Typical High
$16.98
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$7.24
Median
$8.51
Typical High
$11.22

Where Vermont 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.

Vermont· 19th of 51

$112

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.