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Initial Preventive Physical Examination

Ohio 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 $166 · 10th–90th $126$2090%20%40%10th90th$166Professionalmedian $141 · 10th–90th $93$2190%20%10th90th$141$0.2$1.0$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
$125.89
Median
$169.82
Typical High
$208.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$144.54
Typical High
$208.93
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
$154.88
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$117.49
Typical High
$208.93
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$177.83
Typical High
$338.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$162.18
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$165.96
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$128.82
Typical High
$380.19
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$151.36
Typical High
$269.15