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Annual Wellness Visit, Initial

California rates for HCPCS G0438

Annual wellness visit; includes a personalized prevention plan of service (PPS), initial visit

Rates data updated July 2026.

Facilitymedian $214 · 10th–90th $158$3310%10%20%10th90th$214Professionalmedian $191 · 10th–90th $115$5500%10%10th90th$191$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
$134.90
Median
$208.93
Typical High
$1,047.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$181.97
Typical High
$575.44
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$245.47
Typical High
$676.08
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$154.88
Typical High
$173.78
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$154.88
Typical High
$177.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$229.09
Typical High
$257.04
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$204.17
Typical High
$354.81
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$269.15
Typical High
$549.54
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$323.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$177.83
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$234.42
Typical High
$288.40
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$190.55
Typical High
$331.13
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,348.96
Typical High
$1,348.96
Molina
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$204.17
Typical High
$316.23
Providence
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$194.98
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
United
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$169.82
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$181.97
Typical High
$346.74