go back

Massachusetts rates for HCPCS G0438

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

Facilitymedian $214 · 10th–90th $158$3800%10%20%10th90th$214Professionalmedian $191 · 10th–90th $135$4070%10%10th90th$191$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
$158.49 / $158.49 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $380.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$134.90 / $208.93 / $416.87
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $213.80 / $1,047.13
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $229.09 / $512.86
AllWays Health Partners
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$77.62 / $109.65 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $323.59 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $190.55
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $229.09 / $338.84
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $346.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $316.23 / $478.63
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $213.80 / $1,047.13
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $229.09 / $512.86
Mass General Brigham
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$77.62 / $109.65 / $223.87
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $173.78 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $251.19 / $478.63