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Annual Checkup, New Patient (Ages 18-39)

Connecticut rates for HCPCS 99385

A comprehensive first-time wellness visit for an adult patient between about 18 and 39 who is new to this provider, focused on preventive care rather than an existing illness. It typically includes a full health history, an age-appropriate physical exam, and counseling on preventive topics such as screenings, immunizations, and healthy lifestyle habits. It's meant to establish a baseline and catch potential health issues early.

Rates data updated October 2026.

How much does Annual Checkup, New Patient (Ages 18-39) cost?

$148

Typical physician fee. In Connecticut, October 2026.

Insurers have agreed to pay about $148 for this service. Most negotiated rates run $117 to $178.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $631 · 10th to 90th $631 to $631Professionalmedian $148 · 10th to 90th $102 to $219
$100$200$500facility $631professional $148

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
Professional
Modifier
None
Typical Low
$91.20
Median
$120.23
Typical High
$162.18
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$151.36
Typical High
$218.78
Cigna
Setting
Facility
Modifier
None
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
Cigna
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$147.91
Typical High
$199.53
ConnectiCare
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$138.04
Typical High
$204.17
Health New England
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$213.80
Typical High
$239.88
United
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$141.25
Typical High
$234.42
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
$44.67
Median
$58.88
Typical High
$79.43
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$13.49
Median
$17.78
Typical High
$23.99
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$9.12
Median
$11.75
Typical High
$15.85

Where Connecticut sits

The same service costs 2.7 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.

Connecticut· 15th of 51

$148

AK $251DC $93.33

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.