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Annual Wellness Visit, Initial

Maine 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?

$182

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $182 for this service. Most negotiated rates run $158 to $288.

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.

How much rates vary

Facilitymedian $158 · 10th to 90th $95 to $158Professionalmedian $182 · 10th to 90th $135 to $427
$100.0$200.0$500.0$1.0Kfacility $158professional $182

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. Small sample; interpret with caution. 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
$158.49
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$158.49
Typical High
$199.53
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$177.83
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$302.00
Typical High
$524.81
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$162.18
Typical High
$245.47
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$239.88
Typical High
$398.11

Where Maine sits

The same service costs 1.7 times more in Minnesota than in Texas. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Maine $182 · 15th of 51
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.