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Annual Wellness Visit, Initial

Michigan 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?

$170

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $170 for this service. The price depends on where it is billed: about $170 from a physician practice, and about $166 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 8 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$170$148 to $214
FacilityA hospital or hospital-owned outpatient department$166$162 to $195

How much rates vary

Facilitymedian $166 · 10th to 90th $162 to $219Professionalmedian $170 · 10th to 90th $120 to $282
$50.0$100.0$200.0$500.0$1.0Kfacility $166professional $170

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
$162.18
Median
$162.18
Typical High
$165.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$165.96
Typical High
$275.42
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$114.82
Typical High
$426.58
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$131.83
Typical High
$154.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$288.40
CareSource
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$199.53
Typical High
$218.78
CareSource
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$208.93
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$229.09
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$165.96
Typical High
$275.42
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$169.82
Typical High
$275.42
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$186.21
Typical High
$194.98
United
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$173.78
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$190.55
Typical High
$346.74

Where Michigan 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.

Michigan $170 · 31st 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.