go back

Annual Wellness Visit, Initial

New Mexico 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?

$155

Typical negotiated rate. In New Mexico, October 2026.

Insurers have agreed to pay about $155 for this service. The price depends on where it is billed: about $155 from a physician practice, and about $589 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$155$141 to $195
FacilityA hospital or hospital-owned outpatient department$589$195 to $759

How much rates vary

Facilitymedian $589 · 10th to 90th $170 to $933Professionalmedian $155 · 10th to 90th $117 to $240
$50$100$200$500$1Kfacility $589professional $155

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$194.98
Aetna
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$194.98
Typical High
$194.98
BCBS New Mexico
Setting
Facility
Modifier
None
Typical Low
$169.82
Median
$616.60
Typical High
$933.25
BCBS New Mexico
Setting
Professional
Modifier
None
Typical Low
$117.49
Median
$151.36
Typical High
$173.78
Cigna
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Molina
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$190.55
Typical High
$190.55
Providence
Setting
Facility
Modifier
None
Typical Low
$169.82
Median
$169.82
Typical High
$194.98
Providence
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$194.98
United
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
United
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$234.42
Typical High
$288.40

Where New Mexico 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 Mexico· 43rd of 51

$155

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.