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Annual Wellness Visit, Initial

New Jersey 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?

$158

Typical physician fee. In New Jersey, October 2026.

Insurers have agreed to pay about $158 for this service. Most negotiated rates run $141 to $182.

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.

How much rates vary

Facilitymedian $182 · 10th to 90th $158 to $182Professionalmedian $158 · 10th to 90th $135 to $209
$100$200facility $182professional $158

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$181.97
Typical High
$181.97
Aetna
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$208.93
AmeriHealth
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$147.91
Typical High
$331.13
Cigna
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$251.19
Typical High
$288.40
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$239.88
United
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$173.78
United
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$144.54
Typical High
$181.97

Where New Jersey 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.

New Jersey· 37th of 51

$158

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.