Initial Medicare preventive physical exam visit

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR Exam Init Preventive Phys New Visit During 1st 12 Mo of Mcare Enrollment

Payers reporting HCPCS G0402

Payer pricing summary

Low

$49

Average

$2.1k

Median

$215

High

$40.5k

Payer rate distribution

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#
1	Medica professional · fee schedule · outpatient · +19 other terms	29	$168	$163	$56	35%	4–40	$31 – $323
2	Humana fee schedule · outpatient · +30 other terms	291	$131	$177	$95	54%	2–20	$1 – $771
3	Ucare professional · fee schedule · outpatient · +17 other terms	24	$144	$150	$35	23%	2–20	$90 – $257
4	Aetna fee schedule · outpatient · +36 other terms	398	$141	$177	$121	68%	1–10	$1 – $1.5k
5	UnitedHealthcare fee schedule · outpatient · +37 other terms	323	$138	$185	$172	93%	1–10	$1 – $3.8k
6	Blue Cross Blue Shield fee schedule · outpatient · +29 other terms	304	$246	$325	$183	56%	1–10	$0 – $1.1k
7	WellCare fee schedule · outpatient · +24 other terms	125	$129	$148	$44	30%	1–10	$98 – $302
8	Regence professional · fee schedule · outpatient · +18 other terms	34	$144	$181	$59	33%	1–10	$91 – $408
9	Cigna fee schedule · outpatient · +30 other terms	154	$138	$189	$112	59%	—	$0 – $689
10	Molina fee schedule · outpatient · +27 other terms	125	$160	$174	$70	40%	—	$1 – $557
11	Anthem facility · fee schedule · outpatient · +32 other terms	96	$184	$251	$158	63%	—	$23 – $593
12	Ambetter facility · fee schedule · outpatient · +23 other terms	80	$241	$257	$51	20%	—	$120 – $330
13	Kaiser fee schedule · outpatient · +25 other terms	70	$208	$247	$150	60%	—	$54 – $951
14	Devoted fee schedule · outpatient · +17 other terms	63	$131	$136	$23	17%	—	$124 – $319
15	Optum fee schedule · outpatient · +21 other terms	49	$125	$152	$69	45%	—	$117 – $491
16	Oscar fee schedule · outpatient · +20 other terms	48	$247	$211	$102	48%	—	$1 – $380
17	Highmark facility · fee schedule · outpatient · +19 other terms	41	$206	$217	$155	72%	—	$56 – $588
18	Clover fee schedule · outpatient · +11 other terms	33	$141	$135	$10	7%	—	$120 – $152
19	Caresource facility · fee schedule · outpatient · +20 other terms	32	$216	$204	$59	29%	—	$121 – $375
20	Medicare fee schedule · outpatient · +17 other terms	28	$121	$122	$6	5%	—	$110 – $149
21	MultiPlan fee schedule · outpatient · +18 other terms	27	$212	$226	$70	31%	—	$100 – $456
22	Tricare fee schedule · outpatient · +17 other terms	27	$121	$129	$17	13%	—	$110 – $158
23	Wellmark fee schedule · both · +25 other terms	25	$198	$204	$40	20%	—	$122 – $233
24	First Health fee schedule · outpatient · +17 other terms	21	$139	$160	$51	32%	—	$121 – $308
25	Superior Healthplan facility · fee schedule · outpatient · +4 other terms	21	$140	$138	$3	2%	—	$134 – $141

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