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Procedure price report

First yearly wellness visit with prevention plan

HCPCS G0438the billing code this page is about

Covers the initial annual wellness visit, in which a health risk review is done and a personalized written prevention plan is created; billed once, with later years billed under a separate code.

Hospitals typically charge $205 cash for this outpatient procedure — the median across 117 hospitals that filed a usable cash price; the average of the middle 60% is $211. Most fall between $101 and $349 (20th–80th percentile).

Hospitals
117
States
31
Filings dated
Jan 2024 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 117 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$71$111$205$301$565

The most expensive tenth of hospitals charges at least 7.9× what the cheapest tenth charges ($71 vs $565).

How the prices are spread

$66 – $87: 14 hospitals$66$87 – $114: 12 hospitals$114 – $149: 9 hospitals$114$149 – $195: 12 hospitals$195 – $256: 22 hospitals$195$256 – $336: 20 hospitals$336 – $440: 6 hospitals$336$440 – $577: 7 hospitals$577 – $756: 5 hospitals$577$756 – $991: 4 hospitals$756median $205price bands are equal on a log scale
Hospitals per price band (111 of 117 — the bands cover the 5th to 95th percentile)
FromToHospitals
$66$8714
$87$11412
$114$1499
$149$19512
$195$25622
$256$33620
$336$4406
$440$5777
$577$7565
$756$9914

By state

The median cash price in each state, against the national median of $205.

Alaska: 1 hospital filed a usable price — fewer than 10, so no figureAKMaine: 9 hospitals filed a usable price — fewer than 10, so no figureMEVermont: 1 hospital filed a usable price — fewer than 10, so no figureVTNew Hampshire: 2 hospitals filed a usable price — fewer than 10, so no figureNHWashington: 2 hospitals filed a usable price — fewer than 10, so no figureWAIdaho: no hospital in the corpus filed a usable priceIDMontana: no hospital in the corpus filed a usable priceMTNorth Dakota: no hospital in the corpus filed a usable priceNDMinnesota: 2 hospitals filed a usable price — fewer than 10, so no figureMNIllinois: no hospital in the corpus filed a usable priceILWisconsin: no hospital in the corpus filed a usable priceWIMichigan: median $205 across 24 hospitalsMI$205New York: 5 hospitals filed a usable price — fewer than 10, so no figureNYMassachusetts: 2 hospitals filed a usable price — fewer than 10, so no figureMAOregon: 2 hospitals filed a usable price — fewer than 10, so no figureORNevada: 1 hospital filed a usable price — fewer than 10, so no figureNVWyoming: no hospital in the corpus filed a usable priceWYSouth Dakota: no hospital in the corpus filed a usable priceSDIowa: 5 hospitals filed a usable price — fewer than 10, so no figureIAIndiana: median $67 across 14 hospitalsIN$67Ohio: 8 hospitals filed a usable price — fewer than 10, so no figureOHPennsylvania: median $991 across 10 hospitalsPA$991New Jersey: 7 hospitals filed a usable price — fewer than 10, so no figureNJConnecticut: no hospital in the corpus filed a usable priceCTRhode Island: no hospital in the corpus filed a usable priceRICalifornia: 2 hospitals filed a usable price — fewer than 10, so no figureCAUtah: no hospital in the corpus filed a usable priceUTColorado: 1 hospital filed a usable price — fewer than 10, so no figureCONebraska: 1 hospital filed a usable price — fewer than 10, so no figureNEMissouri: 1 hospital filed a usable price — fewer than 10, so no figureMOKentucky: no hospital in the corpus filed a usable priceKYWest Virginia: 1 hospital filed a usable price — fewer than 10, so no figureWVVirginia: no hospital in the corpus filed a usable priceVAMaryland: 1 hospital filed a usable price — fewer than 10, so no figureMDDelaware: no hospital in the corpus filed a usable priceDEArizona: no hospital in the corpus filed a usable priceAZNew Mexico: 1 hospital filed a usable price — fewer than 10, so no figureNMKansas: no hospital in the corpus filed a usable priceKSArkansas: 1 hospital filed a usable price — fewer than 10, so no figureARTennessee: 2 hospitals filed a usable price — fewer than 10, so no figureTNNorth Carolina: no hospital in the corpus filed a usable priceNCSouth Carolina: 1 hospital filed a usable price — fewer than 10, so no figureSCOklahoma: 2 hospitals filed a usable price — fewer than 10, so no figureOKLouisiana: 1 hospital filed a usable price — fewer than 10, so no figureLAMississippi: 5 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: no hospital in the corpus filed a usable priceALGeorgia: 1 hospital filed a usable price — fewer than 10, so no figureGAHawaii: no hospital in the corpus filed a usable priceHITexas: no hospital in the corpus filed a usable priceTXFlorida: 1 hospital filed a usable price — fewer than 10, so no figureFL
Cash price by state, most expensive first. National median $205. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Pennsylvania PA10$991+383%$149 – $991
Michigan MI24$2050%$165 – $231
Indiana IN14$67−68%$58 – $104
Maine ME9not enough hospitals filed a usable price
Ohio OH8not enough hospitals filed a usable price
New Jersey NJ7not enough hospitals filed a usable price
Iowa IA5not enough hospitals filed a usable price
Mississippi MS5not enough hospitals filed a usable price
New York NY5not enough hospitals filed a usable price
California CA2not enough hospitals filed a usable price
Massachusetts MA2not enough hospitals filed a usable price
Minnesota MN2not enough hospitals filed a usable price
New Hampshire NH2not enough hospitals filed a usable price
Oklahoma OK2not enough hospitals filed a usable price
Oregon OR2not enough hospitals filed a usable price
Tennessee TN2not enough hospitals filed a usable price
Washington WA2not enough hospitals filed a usable price
Alaska AK1not enough hospitals filed a usable price
Arkansas AR1not enough hospitals filed a usable price
Colorado CO1not enough hospitals filed a usable price
Florida FL1not enough hospitals filed a usable price
Georgia GA1not enough hospitals filed a usable price
Louisiana LA1not enough hospitals filed a usable price
Maryland MD1not enough hospitals filed a usable price
Missouri MO1not enough hospitals filed a usable price
Nebraska NE1not enough hospitals filed a usable price
New Mexico NM1not enough hospitals filed a usable price
Nevada NV1not enough hospitals filed a usable price
South Carolina SC1not enough hospitals filed a usable price
Vermont VT1not enough hospitals filed a usable price
West Virginia WV1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $205.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care82$205$109 – $366
Children’s1fewer than 20 hospitals
Critical access33$181$88 – $271
Ownership
For-profit8fewer than 20 hospitals
Government16fewer than 20 hospitals
Non-profit92$205$97 – $319
System affiliation
Part of a system93$205$89 – $307
Independent24$235$118 – $467

Cash price vs list price

Median list price (chargemaster)$410
Median cash price$205
Cash as a share of list, median hospital51%

At the typical hospital, asking for the cash price cuts the list price by about 49%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

How complete is this

117 of the 3,956 hospitals with a price file in our corpus (3%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 128 hospitals that filed this code at all gave us
Usable cash price — counted117
Cash price carrying a plausibility flag — shown on the compare tool, excluded here2
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded9
Hospitals that filed this code128

Sections not shown for this setting

  • Against Medicare: Medicare has no separately payable national outpatient (OPPS) rate for this code, so there is nothing honest to compare against.
  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Hospitals file this code under descriptions such as HC Exam/Treatment Room.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “First yearly wellness visit with prevention plan (CPT G0438) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-g0438-first-yearly-wellness-visit-with-prevention-plan