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Initial Preventive Physical Examination

New Jersey 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?

$148

Typical physician fee. In New Jersey, July 2026.

Insurers have agreed to pay about $148 for this service. Most negotiated rates run $126 to $178.

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.

How much rates vary

Facilitymedian $91 · 10th to 90th $91 to $490Professionalmedian $148 · 10th to 90th $100 to $219
$100$200$500facility $91professional $148

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
$91.20
Median
$91.20
Typical High
$91.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$138.04
Typical High
$199.53
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$104.71
Median
$169.82
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$131.83
Typical High
$131.83
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$288.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$245.47
Typical High
$363.08
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$416.87
Typical High
$660.69
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$158.49
Typical High
$213.80
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$162.18
Typical High
$316.23

Where New Jersey sits

The same service costs 1.9 times more in Minnesota 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.

New Jersey· 31st of 51

$148

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.