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Annual Checkup, New Patient (Ages 18-39)

North Carolina 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?

$158

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $129 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$158$115 to $219
FacilityA hospital or hospital-owned outpatient department$129$102 to $166

How much rates vary

Facilitymedian $129 · 10th to 90th $87 to $240Professionalmedian $158 · 10th to 90th $95 to $302
$100$200$500facility $129professional $158

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
$95.50
Median
$223.87
Typical High
$323.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$134.90
Typical High
$426.58
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$141.25
Typical High
$218.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$181.97
Typical High
$295.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$141.25
Typical High
$251.19
Medcost
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$138.04
Typical High
$239.88
Medcost
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$128.82
Typical High
$208.93
Medcost
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$331.13
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$181.97
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$147.91
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$117.49
Typical High
$204.17
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83

Where North Carolina 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.

North Carolina· 10th of 51

$158

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.