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Annual Checkup, New Patient (Ages 40-64)

North Carolina 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?

$182

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $182 for this service. The price depends on where it is billed: about $186 from a physician practice, and about $151 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 8 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$186$135 to $251
FacilityA hospital or hospital-owned outpatient department$151$123 to $200

How much rates vary

Facilitymedian $151 · 10th to 90th $107 to $282Professionalmedian $186 · 10th to 90th $115 to $363
$10.0$20.0$50.0$100.0$200.0$500.0$1.0Kfacility $151professional $186

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
$114.82
Median
$295.12
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$151.36
Typical High
$478.63
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$147.91
Typical High
$239.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$346.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$165.96
Typical High
$295.12
Medcost
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$165.96
Typical High
$281.84
Medcost
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$147.91
Typical High
$245.47
Medcost
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$380.19
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$213.80
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$144.54
Typical High
$204.17
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$138.04
Typical High
$239.88
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99

Where North Carolina 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.

North Carolina $182 · 11th 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.