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Annual Wellness Visit, Initial

Colorado rates for HCPCS G0438

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

Rates data updated July 2026.

How much does Annual Wellness Visit, Initial cost?

$174

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $170 from a physician practice, and about $219 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$170$141 to $195
FacilityA hospital or hospital-owned outpatient department$219$178 to $282

How much rates vary

Facilitymedian $219 · 10th to 90th $155 to $316Professionalmedian $170 · 10th to 90th $120 to $275
$100$200$500facility $219professional $170

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
$239.88
Median
$288.40
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$251.19
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$169.82
Typical High
$263.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$204.17
Typical High
$316.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$173.78
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$208.93
Typical High
$323.59
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$281.84
Typical High
$426.58
Select Health
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$181.97
Typical High
$302.00
United
Setting
Facility
Modifier
Global
Typical Low
$0.17
Median
$60.26
Typical High
$288.40
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$218.78
Typical High
$338.84

Where Colorado sits

The same service costs 1.7 times more in Minnesota than in Texas. 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.

Colorado· 19th of 51

$174

MN $257TX $148

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.