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Annual Checkup, New Patient (Ages 18-39)

West Virginia 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 West Virginia, July 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $166 from a physician practice, and about $145 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 5 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$166$112 to $229
FacilityA hospital or hospital-owned outpatient department$145$115 to $166

How much rates vary

Facilitymedian $145 · 10th to 90th $93 to $229Professionalmedian $166 · 10th to 90th $87 to $263
$100$200$500facility $145professional $166

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
$102.33
Median
$144.54
Typical High
$229.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$169.82
Typical High
$263.03
CareSource
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$97.72
Typical High
$120.23
CareSource
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$128.82
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$131.83
Typical High
$645.65
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$151.36
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$131.83
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$114.82
Typical High
$177.83

Where West Virginia 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.

West Virginia· 12th 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.