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Annual Checkup, New Patient (Ages 18-39)

Vermont 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?

$135

Typical physician fee. In Vermont, October 2026.

Insurers have agreed to pay about $135 for this service. Most negotiated rates run $105 to $174.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $135 · 10th to 90th $95 to $214
$100$200professional $135

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
$91.20
Median
$117.49
Typical High
$147.91
BCBS Vermont
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$213.80
Typical High
$213.80
Cigna
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$134.90
Typical High
$151.36
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$158.49
Typical High
$204.17
United
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$138.04
Typical High
$186.21
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
$46.77
Median
$52.48
Typical High
$66.07
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$13.80
Median
$15.49
Typical High
$19.95
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$9.33
Median
$10.47
Typical High
$13.18

Where Vermont 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.

Vermont· 21st of 51

$135

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.