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Annual Wellness Visit, Initial

Tennessee 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 Tennessee, 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 $309 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 6 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$141 to $195
FacilityA hospital or hospital-owned outpatient department$309$240 to $1,047

How much rates vary

Facilitymedian $309 · 10th to 90th $191 to $1,047Professionalmedian $162 · 10th to 90th $126 to $295
$100$200$500$1Kfacility $309professional $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
$281.84
Median
$281.84
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$162.18
Typical High
$275.42
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$147.91
Median
$263.03
Typical High
$309.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$154.88
Typical High
$158.49
BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$223.87
Typical High
$331.13
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
$141.25
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,348.96
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$234.42
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$186.21
Typical High
$295.12

Where Tennessee 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.

Tennessee· 41st 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.