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New Jersey rates for HCPCS G0438

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

Facilitymedian $204 · 10th–90th $158–$2040%50%10th$204Professionalmedian $182 · 10th–90th $132–$3240%10%10th90th$182$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
$158.49 / $204.17 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $177.83 / $331.13
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$45.71 / $194.98 / $295.12
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $154.88 / $177.83
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$50.12 / $151.36 / $154.88
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $245.47 / $363.08
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $181.97 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $194.98 / $346.74