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Well-Teen Checkup

Vermont rates for HCPCS 99394

This is a preventive checkup for an established adolescent patient, focused on tracking growth and development, screening for physical and mental health concerns, and updating vaccinations. It typically includes a physical exam and age-appropriate counseling on topics like nutrition, safety, and healthy habits. It's not used to treat a specific illness or new health complaint.

Rates data updated October 2026.

How much does Well-Teen Checkup cost?

$117

Typical physician fee. In Vermont, October 2026.

Insurers have agreed to pay about $117 for this service. Most negotiated rates run $91.20 to $148.

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

Professionalmedian $117 · 10th to 90th $85 to $182
$100$200professional $117

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$104.71
Typical High
$128.82
BCBS Vermont
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$181.97
Typical High
$181.97
Cigna
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$117.49
Typical High
$128.82
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$138.04
Typical High
$181.97
United
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$123.03
Typical High
$165.96
3 more rates 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
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$41.69
Median
$45.71
Typical High
$57.54
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$12.30
Median
$13.80
Typical High
$17.38
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$8.32
Median
$9.33
Typical High
$11.48

Where Vermont 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.

Vermont· 20th of 51

$117

AK $219DC $81.28

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.