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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 October 2026.

How much does Annual Checkup, New Patient (Ages 18-39) cost?

$110

Typical physician fee. In West Virginia, October 2026.

Insurers have agreed to pay about $110 for this service. Most negotiated rates run $93.33 to $126.

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

Facilitymedian $200 · 10th to 90th $115 to $288Professionalmedian $110 · 10th to 90th $78 to $178
$100$200$500facility $200professional $110

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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
$107.15
Typical High
$128.82
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$46.77
Median
$48.98
Typical High
$60.26
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$13.80
Median
$14.45
Typical High
$18.20
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$9.33
Median
$9.77
Typical High
$12.30
CareSource
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$131.83
Typical High
$190.55
Cigna
Setting
Facility
Modifier
None
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
Cigna
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$125.89
Typical High
$275.42
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$288.40
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$144.54
Typical High
$165.96
United
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$102.33
Typical High
$158.49
1 more rate 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
Highmark BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$128.82
Median
$147.91
Typical High
$218.78

Where West Virginia 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.

West Virginia· 38th of 51

$110

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.