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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 July 2026.

How much does Annual Wellness Visit, Initial cost?

$186

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $186 for this service. The price depends on where it is billed: about $182 from a physician practice, and about $269 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 6 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$182$138 to $263
FacilityA hospital or hospital-owned outpatient department$269$186 to $288

How much rates vary

Facilitymedian $269 · 10th to 90th $158 to $339Professionalmedian $182 · 10th to 90th $115 to $363
$100.0$1.0K$10.0Kfacility $269professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$169.82
Typical High
$549.54
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$165.96
Typical High
$263.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$66,069.34
Typical High
$81,283.05
BCBS
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$263.03
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$288.40
Typical High
$295.12
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$288.40
Typical High
$295.12
Providence
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$208.93
Typical High
$354.81
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$194.98
Typical High
$263.03
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$331.13

Where Montana 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.

Montana $186 · 12th 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.