go back

Annual Wellness Visit, Initial

Indiana 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?

$162

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $162 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $186 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 6 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$162$148 to $191
FacilityA hospital or hospital-owned outpatient department$186$162 to $204

How much rates vary

Facilitymedian $186 · 10th to 90th $158 to $229Professionalmedian $162 · 10th to 90th $129 to $240
$5$10$20$50$100$200facility $186professional $162

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
$158.49
Median
$165.96
Typical High
$229.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$162.18
Typical High
$234.42
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$154.88
Typical High
$165.96
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$141.25
Typical High
$154.88
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$158.49
Typical High
$245.47
CareSource
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$199.53
Typical High
$213.80
CareSource
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$190.55
Typical High
$239.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$162.18
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$177.83
Typical High
$269.15

Where Indiana 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.

Indiana· 38th of 51

$162

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.