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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 October 2026.

How much does Annual Wellness Visit, Initial cost?

$191

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $191 for this service. The price depends on where it is billed: about $191 from a physician practice, and about $245 from a hospital or other facility.

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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$191$166 to $219
FacilityA hospital or hospital-owned outpatient department$245$219 to $646

How much rates vary

Facilitymedian $245 · 10th to 90th $170 to $1,995Professionalmedian $191 · 10th to 90th $141 to $263
$50$100$200$500$1K$2Kfacility $245professional $191

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$204.17
Typical High
$257.04
Aetna
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$165.96
Typical High
$263.03
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$218.78
Median
$263.03
Typical High
$2,818.38
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$218.78
Typical High
$263.03
Cigna
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Hally Health
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$169.82
Typical High
$354.81
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$204.17
Typical High
$218.78
Molina
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$213.80
United
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$186.21
Typical High
$302.00

Where Illinois sits

The same service costs 2.6 times more in North Dakota than in New York. 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.

Illinois· 19th of 51

$191

ND $295NY $115

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.