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Annual Checkup, New Patient (Ages 18-39)

Michigan 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 Michigan, 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 $135 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 8 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 $174
FacilityA hospital or hospital-owned outpatient department$135$112 to $191

How much rates vary

Facilitymedian $135 · 10th to 90th $98 to $191Professionalmedian $129 · 10th to 90th $83 to $269
$100$200$500facility $135professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$134.90
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$128.82
Typical High
$302.00
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$128.82
Typical High
$194.98
BCBS
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$147.91
BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$158.49
Typical High
$169.82
CareSource
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$112.20
Typical High
$125.89
CareSource
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$162.18
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$125.89
Typical High
$275.42
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$131.83
Typical High
$154.88
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$123.03
Typical High
$194.98
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$234.42
Typical High
$457.09
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$109.65
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$128.82
Typical High
$251.19

Where Michigan 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.

Michigan· 29th 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.