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Massachusetts 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 $83 · 10th–90th $54–$2450%10%10th90th$83Professionalmedian $138 · 10th–90th $71–$2950%5%10th90th$138$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$77.62 / $91.20 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $131.83 / $302.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $91.20 / $467.74
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $371.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $190.55
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $144.54 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $125.89 / $234.42
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $83.18 / $117.49
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $151.36 / $218.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $144.54 / $275.42
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $169.82 / $194.98
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $91.20 / $467.74
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $371.54
Tufts
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $58.88 / $89.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $128.82 / $275.42