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Annual Wellness Visit, Initial

South Dakota 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?

$162

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $162 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $339 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$162$148 to $195
FacilityA hospital or hospital-owned outpatient department$339$245 to $550

How much rates vary

Facilitymedian $339 · 10th to 90th $158 to $550Professionalmedian $162 · 10th to 90th $135 to $288
$50$100$200$500facility $339professional $162

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
$309.03
Median
$549.54
Typical High
$549.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$158.49
Typical High
$263.03
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Avera
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$263.03
Typical High
$269.15
Avera
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$257.04
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$186.21
Typical High
$251.19
Medica
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$239.88
Typical High
$363.08
Medica
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$251.19
Typical High
$1,047.13
Midlands
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$389.05
Midlands
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$380.19
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$323.59
United
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$239.88
Typical High
$380.19
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$263.03
Typical High
$263.03

Where South Dakota 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.

South Dakota· 40th of 51

$162

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.