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Initial Preventive Physical Examination

Illinois rates for HCPCS G0402

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of Medicare enrollment

Rates data updated July 2026.

How much does Initial Preventive Physical Examination cost?

$158

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $229 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$158$129 to $191
FacilityA hospital or hospital-owned outpatient department$229$182 to $302

How much rates vary

Facilitymedian $229 · 10th to 90th $170 to $380Professionalmedian $158 · 10th to 90th $115 to $234
$50.0$100.0$200.0$500.0$1.0Kfacility $229professional $158

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
$169.82
Median
$229.09
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$154.88
Typical High
$218.78
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$104.71
Median
$169.82
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$131.83
Typical High
$154.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$239.88
Typical High
$302.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$162.18
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$190.55
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$213.80
Typical High
$371.54
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$162.18
Typical High
$218.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$169.82
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$354.81
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$169.82
Typical High
$302.00

Where Illinois sits

The same service costs 1.9 times more in Minnesota than in Kentucky. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $158 · 19th of 51
MN $257KY $132

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.