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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 July 2026.

How much does Annual Wellness Visit, Initial cost?

$182

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $182 for this service. The price depends on where it is billed: about $182 from a physician practice, and about $191 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$182$158 to $234
FacilityA hospital or hospital-owned outpatient department$191$166 to $234

How much rates vary

Facilitymedian $191 · 10th to 90th $151 to $302Professionalmedian $182 · 10th to 90th $138 to $295
$100$200$500facility $191professional $182

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
$177.83
Median
$190.55
Typical High
$234.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$177.83
Typical High
$295.12
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$245.47
Typical High
$676.08
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$204.17
Typical High
$323.59
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$204.17
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
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$194.98
Typical High
$295.12
Medcost
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$263.03
Typical High
$263.03
Medcost
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$190.55
Typical High
$309.03
Medcost
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$117.49
Typical High
$158.49
Sentara
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$186.21
Typical High
$288.40
Sentara
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$186.21
Typical High
$288.40
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$173.78
Typical High
$229.09
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$194.98
Typical High
$323.59

Where Virginia 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.

Virginia· 14th of 51

$182

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.