go back

North Carolina rates for HCPCS G0438

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

Facilitymedian $191 · 10th–90th $148$3160%20%40%10th90th$191Professionalmedian $209 · 10th–90th $135$3890%10%20%10th90th$209$1.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $181.97 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $165.96 / $338.84
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$114.82 / $194.98 / $331.13
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $154.88 / $323.59
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$50.12 / $131.83 / $154.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $239.88 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $186.21
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $263.03 / $263.03
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $186.21 / $309.03
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $416.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $288.40 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $186.21 / $302.00
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,348.96