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Annual Wellness Visit, Initial

Montana rates for HCPCS G0438

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

Rates data updated October 2026.

How much does Annual Wellness Visit, Initial cost?

$263

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $263 for this service. The price depends on where it is billed: about $263 from a physician practice, and about $263 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$263$191 to $263
FacilityA hospital or hospital-owned outpatient department$263$200 to $302

How much rates vary

Facilitymedian $263 · 10th to 90th $174 to $324Professionalmedian $263 · 10th to 90th $145 to $282
$100$200facility $263professional $263

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$147.91
Typical High
$239.88
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Cigna
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Cigna
Setting
Professional
Modifier
None
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$234.42
Typical High
$323.59
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$218.78
Typical High
$316.23
Providence
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$223.87
Typical High
$263.03
United
Setting
Professional
Modifier
None
Typical Low
$229.09
Median
$275.42
Typical High
$302.00

Where Montana sits

The same service costs 2.6 times more in North Dakota than in New York. 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.

Montana· 7th of 51

$263

ND $295NY $115

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.