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Annual Checkup, New Patient (Ages 18-39)

New Jersey 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?

$126

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $115 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$126$97.72 to $174
FacilityA hospital or hospital-owned outpatient department$115$79.43 to $132

How much rates vary

Facilitymedian $115 · 10th to 90th $79 to $182Professionalmedian $126 · 10th to 90th $79 to $288
$100$200$500facility $115professional $126

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
$79.43
Median
$114.82
Typical High
$181.97
Aetna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$117.49
Typical High
$331.13
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$177.83
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$141.25
Typical High
$239.88
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$147.91
Typical High
$269.15
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$147.91
Typical High
$245.47
United
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$120.23
Typical High
$229.09

Where New Jersey 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.

New Jersey· 31st of 51

$126

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.