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Annual Checkup, New Patient (Ages 40-64)

Texas 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?

$126

Typical negotiated rate. In Texas, July 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $148 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 13 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$126$107 to $155
FacilityA hospital or hospital-owned outpatient department$148$120 to $195

How much rates vary

Facilitymedian $148 · 10th to 90th $98 to $282Professionalmedian $126 · 10th to 90th $93 to $219
$20.0$50.0$100.0$200.0$500.0$1.0Kfacility $148professional $126

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
$95.50
Median
$123.03
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$131.83
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$147.91
Typical High
$194.98
BCBS
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$162.18
Typical High
$489.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$120.23
Typical High
$154.88
Baylor Scott & White
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$151.36
Typical High
$229.09
Christus
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$151.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$158.49
Typical High
$275.42
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$194.98
Typical High
$954.99
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$147.91
Typical High
$257.04
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$194.98
Typical High
$288.40
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$87.10
Typical High
$107.15
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$371.54
Typical High
$380.19
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$190.55
Typical High
$323.59
Providence
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$147.91
Typical High
$257.04
Providence
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$162.18
Typical High
$302.00
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$123.03
Typical High
$177.83
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$138.04
Typical High
$213.80
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$151.36
Typical High
$208.93

Where Texas 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.

Texas $126 · 49th 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.