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Annual Wellness Visit, Initial

Texas rates for HCPCS G0438

Annual wellness visit; includes a personalized prevention plan of service (PPS), initial visit

Rates data updated July 2026.

Facilitymedian $191 · 10th–90th $132$3800%10%10th90th$191Professionalmedian $145 · 10th–90th $117$2510%20%10th90th$145$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
$95.50
Median
$95.50
Typical High
$162.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$162.18
Typical High
$257.04
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$181.97
Typical High
$338.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$154.88
Typical High
$162.18
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$154.88
Typical High
$154.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$138.04
Typical High
$138.04
Baylor Scott & White
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$204.17
Typical High
$281.84
Christus
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$169.82
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
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$190.55
Typical High
$338.84
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$338.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$125.89
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$323.59
Typical High
$645.65
Providence
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$190.55
Typical High
$338.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$194.98
United
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$141.25
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$181.97
Typical High
$281.84
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$169.82
Typical High
$234.42