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Annual Checkup, New Patient (Ages 18-39)

Maine 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?

$129

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $129 for this service. The price depends on where it is billed: about $129 from a physician practice, and about $234 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$129$100 to $186
FacilityA hospital or hospital-owned outpatient department$234$107 to $234

How much rates vary

Facilitymedian $234 · 10th to 90th $79 to $234Professionalmedian $129 · 10th to 90th $79 to $269
$100$200facility $234professional $129

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. 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
Global
Typical Low
$79.43
Median
$234.42
Typical High
$234.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$107.15
Typical High
$181.97
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$134.90
Typical High
$245.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$141.25
Typical High
$251.19
Community Health Options
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$190.55
Typical High
$257.04
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$173.78
Typical High
$323.59
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$107.15
Typical High
$204.17
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$162.18
Typical High
$269.15

Where Maine 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.

Maine· 28th of 51

$129

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.