Annual Physical Exam: Cost, What's Included, and What's Not in 2026

May 30, 2026 · Cost Guide · 7 min read

An annual physical is one of the most common reasons adults visit a primary care office, and one of the most commonly mispriced. Without insurance, a standard adult physical runs $150 to $450 at most primary care offices. With insurance, the visit itself is fully covered as preventive care under the Affordable Care Act — but a single add-on test, a new symptom mentioned in passing, or an out-of-network blood draw can convert a "free" visit into a $400 bill. This guide breaks down what a physical actually costs, what is included, and how to avoid the surprise charges that catch most patients off-guard.

What an Annual Physical Costs Without Insurance

Self-pay pricing varies significantly by clinic type and geography. These ranges reflect 2026 pricing across the U.S. healthcare providers in our directory:

• FQHC or community health center (sliding fee): $25–$80 for income-qualified patients
• Direct Primary Care membership: $50–$150 per month, includes unlimited visits — physicals included
• Retail clinic (CVS MinuteClinic, Walgreens): $99–$179 for a basic adult physical, limited scope
• Independent primary care office (established patient): $150–$300
• Independent primary care office (new patient): $200–$450
• Hospital-affiliated primary care (new patient): $250–$550 plus possible facility fee
• Concierge or executive physical: $500–$3,500 — typically includes extensive labs, imaging, and an extended exam

For uninsured patients, an FQHC or community health center is almost always the lowest-cost option. The sliding-fee scale is based on household income and household size — patients at or below 100% of the Federal Poverty Level typically pay a nominal $25–$35 fee, with sliding tiers up to 200% of FPL.

What an Annual Physical Costs With Insurance

Under the Affordable Care Act, your insurance must cover one preventive visit per 12-month period with no copay, no coinsurance, and no deductible — when:

• You see an in-network provider
• The visit is coded as preventive care (CPT 99381–99397 depending on age)
• The conversation stays focused on preventive screening, risk assessment, and counseling

The covered services include the office visit itself, vital signs, a history and physical exam, age-appropriate cancer screenings (mammography, colonoscopy, cervical cancer screening), age-appropriate immunizations, depression screening, blood pressure screening, and the standard preventive lab panel. The guide to preventive care covered at no cost includes the full list of services covered under the ACA preventive care mandate.

What Is and Is Not Included in a Standard Physical

Included in Every Standard Adult Physical

• Vital signs — blood pressure, heart rate, respiratory rate, temperature, height, weight, BMI
• Health history update — medications, allergies, family history, social history
• Head-to-toe physical exam — heart, lungs, abdomen, skin, lymph nodes, neurological screen
• Age-appropriate screening discussion — cancer screening recommendations, immunization review
• Lifestyle counseling — diet, exercise, tobacco, alcohol, mental health screening

Typically Included for Adults Over 35

• Complete blood count (CBC) — screens for anemia and infection
• Basic or comprehensive metabolic panel — kidney function, electrolytes, glucose
• Lipid panel — total cholesterol, LDL, HDL, triglycerides
• Hemoglobin A1c — diabetes screening (typically every 3 years for low-risk adults)
• TSH — thyroid function (often included though not formally a USPSTF recommendation)

Frequently Included But Not Always Covered

• EKG (electrocardiogram) — typically $50–$150 if billed separately; not USPSTF-recommended for asymptomatic adults
• Urinalysis — typically $10–$30; not USPSTF-recommended for asymptomatic adults but commonly performed
• Vitamin D level — $40–$80; not covered as preventive care under most plans
• Vitamin B12, iron studies, ferritin — $30–$70 each; typically covered only if clinically indicated

Not Included in a Standard Physical

• Imaging — X-rays, ultrasound, CT, MRI — never part of a routine physical
• Specialist consultation — dermatology, cardiology, etc. — referred separately
• Hormone panels — testosterone, estrogen, cortisol — not preventive
• Food sensitivity or allergy testing — not preventive, often $200–$600
• Genetic testing — not preventive unless meets specific family history criteria
• Sports physical or DOT physical — separate visit type, different billing code

The Most Common Reason People Get a Bill After a "Free" Physical

The single biggest source of surprise bills after a preventive visit is the conversion from preventive to problem-oriented billing. Here is how it happens:

You arrive for your annual physical. During the history-taking, the provider asks if anything is bothering you, and you mention a new shoulder pain, or ask about adjusting your blood pressure medication, or describe trouble sleeping. The provider examines the shoulder, discusses medication options, or recommends a sleep evaluation. Because that discussion went beyond preventive screening, the provider documents it as a separately-billable problem-oriented evaluation and adds CPT 99213 (Level 3 office visit, around $90–$150 with insurance) or 99214 (Level 4, around $130–$230) to the claim alongside the preventive code.

Your insurance covers the preventive code at 100% but applies normal cost-sharing to the problem-oriented code — meaning you pay your specialist copay, or the full contracted rate if you have not yet hit your deductible.

How to Avoid This

At the start of the visit, tell the provider directly: "I want to keep this visit strictly preventive. If anything we discuss might be billed as a problem, let me know before you document it and I'll schedule a separate appointment for that issue." Most providers will accommodate this. The discussion of new symptoms is a legitimate billing decision, not a hidden charge — but you have the right to know in advance and decide whether to defer.

Add-On Tests That Trigger Bills

Even when your visit stays preventive, certain add-on tests may not be covered:

• Vitamin D screening — adds $40–$80 in most labs. USPSTF rates the evidence as insufficient for general adult screening, so most plans do not cover it as preventive.
• Comprehensive metabolic panel beyond the basic panel — adds $20–$50 depending on lab
• PSA testing for prostate cancer screening — covered under preventive care for men ages 55–69 with shared decision-making documentation; may not be covered outside that age range
• Carotid ultrasound, heart calcium scoring, full-body imaging — typically marketed as "wellness screening" but rarely covered by insurance
• Hormone panels and food sensitivity testing — almost never covered, typically $150–$400

If you want any of these add-on tests, ask your provider in advance whether they will be covered by your plan, and request a written cost estimate. The guide to lab test and blood work costs includes self-pay pricing for common add-on tests so you can decide whether to skip them or pay out-of-pocket.

Comparing Sites of Care for an Annual Physical

Independent Primary Care Practice

The most common setting and typically the best balance of cost and continuity. Established-patient visits run $150–$300 self-pay, and a long-term relationship with one provider improves diagnostic accuracy and care coordination over time. The guide to choosing a primary care doctor covers what to look for when establishing care.

Hospital-Affiliated Primary Care

Similar care quality but typically 20–40% more expensive due to facility fees billed in addition to the physician fee. Hospital systems also tend to refer internally for specialists and imaging, which can extend cost exposure. Acceptable if you anticipate needing specialist coordination and want everything under one electronic medical record system.

Direct Primary Care (DPC)

Membership-based model where you pay $50–$150/month for unlimited visits. Physicals are included, lab work is often discounted 70–90% through wholesale pricing, and visits are typically 30–60 minutes rather than 15. Best fit for patients who want extended provider time and predictable monthly costs. DPC does not replace catastrophic health insurance.

Retail Clinic (CVS, Walgreens)

Lowest-cost option for patients without an established provider, at $99–$179 for a basic physical. Scope is limited — these clinics typically do not handle complex chronic conditions, do not order imaging, and may not perform the full standard lab panel. Appropriate for healthy adults who need a one-time physical for employment or insurance purposes.

FQHC or Community Health Center

Lowest-cost option overall for uninsured or income-qualified patients, with sliding-fee scale starting at $25–$80. FQHCs accept all insurance including Medicaid and offer the full scope of primary care services. The guide to finding a Medicaid-accepting clinic explains the FQHC system in more detail.

What to Bring to Your Annual Physical

• List of current medications — including over-the-counter, supplements, vitamins, and dosages
• Family medical history — particularly cancer, heart disease, diabetes, and mental health conditions in first-degree relatives
• Records from previous providers — labs, imaging, hospitalizations within the last 5 years
• Immunization records — particularly if you are unsure when you last received tetanus, shingles, or pneumonia vaccines
• List of questions or concerns — but be aware that detailed discussion of new symptoms may convert the visit to problem-oriented billing

Bottom Line on Annual Physical Pricing

A standard annual physical costs $150–$450 self-pay and is fully covered as preventive care under the ACA when you see an in-network provider and the visit stays focused on preventive screening. The most common surprise bills come from converting part of the visit to problem-oriented care or from non-covered add-on labs. Confirm in advance which discussions will be billed as preventive, decline non-covered add-on tests unless you are willing to pay out-of-pocket, and document the encounter type with the billing office if you receive an unexpected bill.

Looking for a primary care provider for your annual physical? Browse healthcare providers by city to compare clinics with transparent pricing and same-week availability, or search clinics near you that publish self-pay rates.