go back

California rates for HCPCS G0438

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

Facilitymedian $214 · 10th–90th $158$3390%10%20%10th90th$214Professionalmedian $186 · 10th–90th $115$4470%10%10th90th$186$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $1,047.13 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $181.97 / $457.09
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$114.82 / $245.47 / $426.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$131.83 / $147.91 / $177.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $229.09 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $204.17 / $363.08
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $269.15 / $549.54
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $218.78 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $186.21
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $234.42 / $288.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $190.55 / $331.13
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,348.96 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $190.55
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $204.17 / $316.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $194.98
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $181.97 / $346.74