go back

Annual Checkup, New Patient (Ages 40-64)

New Jersey 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?

$145

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $145 for this service. The price depends on where it is billed: about $145 from a physician practice, and about $132 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$145$115 to $204
FacilityA hospital or hospital-owned outpatient department$132$107 to $158

How much rates vary

Facilitymedian $132 · 10th to 90th $98 to $209Professionalmedian $145 · 10th to 90th $98 to $309
$20.0$50.0$100.0$200.0$500.0$1.0Kfacility $132professional $145

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
$97.72
Median
$131.83
Typical High
$208.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$138.04
Typical High
$323.59
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$147.91
Typical High
$208.93
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$190.55
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$141.25
Typical High
$141.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$165.96
Typical High
$281.84
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$162.18
Typical High
$309.03
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$169.82
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$138.04
Typical High
$263.03

Where New Jersey 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.

New Jersey $145 · 36th 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.