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Nationwide rates for HCPCS 99381

Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age younger than 1 year)

Facilitymedian $107 · 10th–90th $65–$2090%10%20%10th90th$107Professionalmedian $115 · 10th–90th $65–$2630%10%10th90th$115$0.1$1.0$10.0$100.0$1.0K$10.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $114.82 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $117.49 / $269.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $85.11 / $95.50
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $104.71 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $112.20 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $114.82 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $91.20 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $102.33 / $204.17

See more rates by state

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