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Annual Wellness Visit, Initial

Illinois rates for HCPCS G0438

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

Rates data updated July 2026.

Facilitymedian $219 · 10th–90th $170$3800%20%10th90th$219Professionalmedian $182 · 10th–90th $132$2820%10%20%10th90th$182$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
$169.82
Median
$199.53
Typical High
$380.19
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$169.82
Typical High
$295.12
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$177.83
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$154.88
Typical High
$154.88
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$131.83
Typical High
$154.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$263.03
Typical High
$645.65
BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$218.78
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$186.21
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$263.03
Typical High
$407.38
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$204.17
Typical High
$218.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$169.82
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$190.55
Typical High
$288.40
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$208.93
Typical High
$331.13