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Annual Checkup, New Patient (Ages 18-39)

Illinois 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 July 2026.

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

$135

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $135 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $151 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$135$102 to $182
FacilityA hospital or hospital-owned outpatient department$151$87.10 to $200

How much rates vary

Facilitymedian $151 · 10th to 90th $83 to $251Professionalmedian $135 · 10th to 90th $87 to $263
$100$200$500facility $151professional $135

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$151.36
Typical High
$199.53
Aetna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$134.90
Typical High
$323.59
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$134.90
Typical High
$190.55
BCBS
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$371.54
Typical High
$426.58
BCBS
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$123.03
Typical High
$165.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$144.54
Typical High
$239.88
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$169.82
Typical High
$323.59
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$117.49
Typical High
$173.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$194.98
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$131.83
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$134.90
Typical High
$239.88

Where Illinois sits

The same service costs 2.1 times more in Minnesota than in Delaware. 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.

Illinois· 20th of 51

$135

MN $214DE $102

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.