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Maine 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 $62 · 10th–90th $62–$890%20%40%90th$62Professionalmedian $110 · 10th–90th $65–$2400%10%10th90th$110$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $107.15 / $234.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $114.82 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $117.49 / $213.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $138.04 / $275.42
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $100.00 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $134.90 / $223.87