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New Jersey 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 $102 · 10th–90th $62–$1550%20%10th90th$102Professionalmedian $110 · 10th–90th $65–$2240%5%10%10th90th$110$50.0$100.0$200.0$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
$61.66 / $102.33 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $109.65 / $229.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $107.15 / $117.49
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $138.04 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $114.82 / $208.93
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $131.83 / $208.93
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $112.20 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $97.72 / $186.21