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Annual Wellness Visit, Initial

North Carolina rates for HCPCS G0438

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

Rates data updated July 2026.

Facilitymedian $191 · 10th–90th $148$3240%20%10th90th$191Professionalmedian $219 · 10th–90th $135$4070%10%10th90th$219$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
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$162.18
Typical High
$302.00
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$158.49
Typical High
$354.81
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$154.88
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$154.88
Typical High
$154.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$239.88
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$177.83
Medcost
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$263.03
Typical High
$263.03
Medcost
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$186.21
Typical High
$309.03
Medcost
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$416.87
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$302.00
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$181.97
Typical High
$309.03
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,348.96