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Annual Checkup, New Patient (Ages 18-39)

Pennsylvania 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.

Facilitymedian $138 · 10th–90th $85$3090%10%20%10th90th$138Professionalmedian $145 · 10th–90th $87$2880%10%20%10th90th$145$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$125.89
Typical High
$309.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$144.54
Typical High
$295.12
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$131.83
Typical High
$194.98
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$147.91
Typical High
$147.91
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$144.54
Typical High
$218.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$114.82
Typical High
$114.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$128.82
Typical High
$208.93
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$147.91
Typical High
$275.42
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$102.33
Typical High
$204.17
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$100.00
Typical High
$281.84
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$138.04
Typical High
$186.21
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$147.91
Typical High
$154.88
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$114.82
Typical High
$263.03
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$123.03
Typical High
$257.04
Optum
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$138.04
Typical High
$165.96
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$134.90
Typical High
$186.21
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$144.54
Typical High
$229.09
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$123.03
Typical High
$213.80