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Initial Preventive Physical Examination

New York 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?

$148

Typical negotiated rate. In New York, October 2026.

Insurers have agreed to pay about $148 for this service. The price depends on where it is billed: about $148 from a physician practice, and about $132 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 10 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$148$132 to $166
FacilityA hospital or hospital-owned outpatient department$132$105 to $219

How much rates vary

Facilitymedian $132 · 10th to 90th $76 to $331Professionalmedian $148 · 10th to 90th $100 to $195
$100$200$500facility $132professional $148

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
$100.00
Median
$131.83
Typical High
$239.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$100.00
Typical High
$177.83
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$154.88
Typical High
$190.55
CDPHP
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$234.42
Cigna
Setting
Facility
Modifier
None
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Cigna
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Emblem Health
Setting
Facility
Modifier
None
Typical Low
$75.86
Median
$128.82
Typical High
$426.58
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$204.17
Typical High
$346.74
Excellus BCBS
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$154.88
Typical High
$199.53
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$97.72
Median
$616.60
Typical High
$741.31
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$154.88
Typical High
$194.98
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$223.87
United
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$309.03
Typical High
$380.19
United
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$134.90
Typical High
$199.53
Univera
Setting
Facility
Modifier
None
Typical Low
$123.03
Median
$141.25
Typical High
$141.25
Univera
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$154.88
Typical High
$194.98

Where New York 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.

New York· 37th of 51

$148

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.