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Annual Checkup, Established Patient (Ages 18-39)

Michigan rates for HCPCS 99395

A comprehensive yearly wellness visit for an adult patient between about 18 and 39 who has been seen by this provider before, focused on preventive care rather than an existing illness. It typically includes a full health history update, an age-appropriate physical exam, and counseling on preventive topics such as screenings, immunizations, and lifestyle. It's meant to catch potential health issues early rather than address a current specific complaint.

Rates data updated July 2026.

How much does Annual Checkup, Established Patient (Ages 18-39) cost?

$120

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $120 for this service. The price depends on where it is billed: about $120 from a physician practice, and about $95.50 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$120$93.33 to $170
FacilityA hospital or hospital-owned outpatient department$95.50$93.33 to $126

How much rates vary

Facilitymedian $95 · 10th to 90th $78 to $155Professionalmedian $120 · 10th to 90th $76 to $269
$5.0$10.0$20.0$50.0$100.0$200.0$500.0facility $95professional $120

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
$77.62
Median
$95.50
Typical High
$154.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$120.23
Typical High
$275.42
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$117.49
Typical High
$177.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$144.54
Typical High
$144.54
CareSource
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$104.71
Typical High
$114.82
CareSource
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$147.91
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$112.20
Typical High
$251.19
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$120.23
Typical High
$151.36
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$109.65
Typical High
$177.83
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$208.93
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$95.50
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$114.82
Typical High
$245.47

Where Michigan sits

The same service costs 2.0 times more in Wisconsin than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Michigan $120 · 24th of 51
WI $191DC $93.33

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.