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Annual Checkup, New Patient (Ages 18-39)

Montana 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 negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $148 from a physician practice, and about $155 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$148$132 to $204
FacilityA hospital or hospital-owned outpatient department$155$141 to $234

How much rates vary

Facilitymedian $155 · 10th to 90th $138 to $251Professionalmedian $148 · 10th to 90th $100 to $209
$100$200facility $155professional $148

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$107.15
Typical High
$177.83
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$173.78
Typical High
$204.17
Cigna
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$239.88
Cigna
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$144.54
Typical High
$204.17
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$162.18
Typical High
$251.19
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$151.36
Typical High
$245.47
Providence
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$239.88
Providence
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$138.04
Typical High
$208.93
United
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$177.83
Typical High
$229.09
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
$38.90
Median
$56.23
Typical High
$89.13
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$11.48
Median
$16.98
Typical High
$26.92
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$7.76
Median
$11.22
Typical High
$17.78

Where Montana 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.

Montana· 16th 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.