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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 October 2026.

How much does Initial Preventive Physical Examination cost?

$162

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $162 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $240 from a hospital or other facility.

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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$162$132 to $191
FacilityA hospital or hospital-owned outpatient department$240$191 to $589

How much rates vary

Facilitymedian $240 · 10th to 90th $162 to $1,318Professionalmedian $162 · 10th to 90th $126 to $219
$50$100$200$500$1K$2Kfacility $240professional $162

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
Facility
Modifier
None
Typical Low
$128.82
Median
$162.18
Typical High
$269.15
Aetna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$162.18
Typical High
$204.17
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$281.84
Typical High
$1,548.82
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$162.18
Typical High
$208.93
Cigna
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Hally Health
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$169.82
Typical High
$316.23
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$162.18
Typical High
$218.78
Molina
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
None
Typical Low
$316.23
Median
$316.23
Typical High
$354.81
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$158.49
Typical High
$263.03

Where Illinois sits

The same service costs 2.8 times more in Alaska than in Kentucky. 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.

Illinois· 23rd of 51

$162

AK $339KY $123

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.