go back

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 July 2026.

Facilitymedian $158 · 10th–90th $158$1580%50%$158Professionalmedian $170 · 10th–90th $129$2630%10%20%10th90th$170$50.0$100.0$200.0$500.0$1.0K

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
$158.49
Median
$158.49
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$165.96
Typical High
$257.04
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$45.71
Median
$181.97
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$154.88
Typical High
$162.18
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$141.25
Median
$141.25
Typical High
$154.88
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$302.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$245.47
Typical High
$363.08
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$181.97
Typical High
$229.09
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$194.98
Typical High
$363.08