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Annual Wellness Visit, Initial

Virginia 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?

$174

Typical negotiated rate. In Virginia, October 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $174 from a physician practice, and about $195 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$174$151 to $195
FacilityA hospital or hospital-owned outpatient department$195$166 to $251

How much rates vary

Facilitymedian $195 · 10th to 90th $158 to $631Professionalmedian $174 · 10th to 90th $141 to $219
$200$500$1K$2K$5K$10Kfacility $195professional $174

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
$177.83
Median
$234.42
Typical High
$251.19
Aetna
Setting
Professional
Modifier
None
Typical Low
$177.83
Median
$190.55
Typical High
$251.19
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$177.83
Typical High
$218.78
CareFirst
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$158.49
Typical High
$186.21
Cigna
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$141.25
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$169.82
Median
$194.98
Typical High
$251.19
Medcost
Setting
Professional
Modifier
None
Typical Low
$245.47
Median
$263.03
Typical High
$263.03
Medcost
Setting
Facility
Modifier
None
Typical Low
$131.83
Median
$234.42
Typical High
$269.15
Medcost
Setting
Professional
Modifier
None
Typical Low
$38.90
Median
$117.49
Typical High
$158.49
Sentara
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$194.98
Typical High
$870.96
Sentara
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$165.96
Typical High
$229.09
United
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
United
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$158.49
Typical High
$269.15

Where Virginia 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.

Virginia· 29th of 51

$174

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.