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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 July 2026.

Facilitymedian $178 · 10th–90th $151$2400%20%10th90th$178Professionalmedian $158 · 10th–90th $110$2750%20%10th90th$158$0.2$1.0$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
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$208.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$165.96
Typical High
$295.12
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$38.90
Median
$181.97
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$154.88
Typical High
$158.49
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$154.88
Typical High
$154.88
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$141.25
Typical High
$229.09
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$173.78
Typical High
$338.84
CareSource
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$165.96
Typical High
$213.80
CareSource
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$165.96
Typical High
$218.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$144.54
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$158.49
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$186.21
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$177.83
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$181.97
Typical High
$316.23