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Initial Preventive Physical Examination

North Carolina 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 $162 · 10th–90th $117$2690%10%10th90th$162Professionalmedian $174 · 10th–90th $120$3390%10%10th90th$174$5.0$20.0$100.0$500.0

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
$131.83
Median
$162.18
Typical High
$223.87
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$154.88
Typical High
$263.03
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$104.71
Median
$162.18
Typical High
$467.74
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$131.83
Typical High
$131.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$199.53
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Medcost
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$165.96
Typical High
$165.96
Medcost
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$162.18
Typical High
$269.15
Medcost
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$407.38
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$208.93
Typical High
$363.08
United
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$218.78
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$151.36
Typical High
$251.19
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,348.96