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Annual Wellness Visit, Initial

Ohio 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?

$141

Typical negotiated rate. In Ohio, October 2026.

Insurers have agreed to pay about $141 for this service. The price depends on where it is billed: about $141 from a physician practice, and about $437 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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$141$123 to $162
FacilityA hospital or hospital-owned outpatient department$437$191 to $525

How much rates vary

Facilitymedian $437 · 10th to 90th $158 to $562Professionalmedian $141 · 10th to 90th $110 to $224
$20$50$100$200$500facility $437professional $141

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
$158.49
Median
$457.09
Typical High
$562.34
Aetna
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$302.00
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$138.04
Typical High
$173.78
Aultcare
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$173.78
Typical High
$338.84
CareSource
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$165.96
Typical High
$245.47
Cigna
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Medical Mutual of Ohio
Setting
Facility
Modifier
None
Typical Low
$13.18
Median
$154.88
Typical High
$213.80
Medical Mutual of Ohio
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$141.25
Typical High
$346.74
Molina
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$147.91
Typical High
$229.09
SummaCare
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$165.96
Typical High
$204.17
United
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$158.49
Typical High
$190.55
United
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$165.96
Typical High
$234.42

Where Ohio 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.

Ohio· 49th of 51

$141

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.