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Annual Checkup, New Patient (Ages 40-64)

Illinois rates for HCPCS 99386

A comprehensive first-time wellness visit for an adult patient between about 40 and 64 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 that become more relevant with age, such as certain screenings and lifestyle guidance. 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 40-64) cost?

$155

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $155 for this service. The price depends on where it is billed: about $155 from a physician practice, and about $186 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$155$120 to $209
FacilityA hospital or hospital-owned outpatient department$186$105 to $234

How much rates vary

Facilitymedian $186 · 10th to 90th $91 to $269Professionalmedian $155 · 10th to 90th $105 to $295
$50.0$100.0$200.0$500.0facility $186professional $155

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
$91.20
Median
$186.21
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$346.74
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$151.36
Typical High
$208.93
BCBS
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$446.68
Typical High
$501.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$144.54
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$169.82
Typical High
$275.42
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$199.53
Typical High
$371.54
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$141.25
Typical High
$199.53
Molina
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$229.09
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$144.54
Typical High
$204.17
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$165.96
Typical High
$281.84

Where Illinois sits

The same service costs 2.1 times more in Minnesota than in Delaware. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $155 · 21st of 51
MN $257DE $120

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.