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Annual Checkup, New Patient (Ages 18-39)

Delaware 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?

$105

Typical physician fee. In Delaware, October 2026.

Insurers have agreed to pay about $105 for this service. Most negotiated rates run $85.11 to $123.

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 $115 · 10th to 90th $85 to $115Professionalmedian $105 · 10th to 90th $74 to $135
$100$200facility $115professional $105

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
$85.11
Median
$85.11
Typical High
$114.82
Aetna
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$109.65
Typical High
$134.90
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$41.69
Median
$48.98
Typical High
$57.54
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$12.59
Median
$14.79
Typical High
$17.38
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$8.32
Median
$9.77
Typical High
$11.48
Cigna
Setting
Facility
Modifier
None
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
Cigna
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$107.15
Typical High
$131.83
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$229.09
Typical High
$251.19
United
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$102.33
Typical High
$138.04
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
$114.82
Median
$134.90
Typical High
$239.88

Where Delaware 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.

Delaware· 46th of 51

$105

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.