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Kentucky 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 $85 · 10th–90th $65–$1120%20%10th90th$85Professionalmedian $107 · 10th–90th $65–$2340%10%10th90th$107$1.0$5.0$20.0$100.0$500.0

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
$64.57 / $69.18 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $109.65 / $251.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $107.15 / $134.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $89.13 / $125.89
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $81.28 / $123.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $114.82 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $112.20 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $112.20 / $512.86
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $75.86 / $109.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $93.33 / $147.91