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Annual Wellness Visit, Initial

Massachusetts rates for HCPCS G0438

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

Rates data updated July 2026.

Facilitymedian $209 · 10th–90th $158$3800%20%10th90th$209Professionalmedian $200 · 10th–90th $135$4570%10%10th90th$200$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
$158.49
Median
$158.49
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$169.82
Typical High
$457.09
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$194.98
Median
$263.03
Typical High
$263.03
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$213.80
Typical High
$1,047.13
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$229.09
Typical High
$537.03
AllWays Health Partners
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$81.28
Median
$114.82
Typical High
$234.42
BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$331.13
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$177.83
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$229.09
Typical High
$338.84
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$234.42
Typical High
$346.74
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$316.23
Typical High
$467.74
Health New England
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$213.80
Typical High
$1,047.13
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$229.09
Typical High
$537.03
Mass General Brigham
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$81.28
Median
$114.82
Typical High
$234.42
Tufts
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$288.40
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$173.78
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$269.15
Typical High
$489.78