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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.

Facilitymedian $229 · 10th–90th $170$3800%20%10th90th$229Professionalmedian $158 · 10th–90th $112$2340%10%20%10th90th$158$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

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