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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 July 2026.

How much does Annual Wellness Visit, Initial cost?

$170

Typical physician fee. In New Jersey, July 2026.

Insurers have agreed to pay about $170 for this service. Most negotiated rates run $148 to $195.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $158 · 10th to 90th $158 to $158Professionalmedian $170 · 10th to 90th $132 to $263
$100$200$500facility $158professional $170

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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

Where New Jersey sits

The same service costs 1.7 times more in Minnesota than in Texas. 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· 29th of 51

$170

MN $257TX $148

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.