go back

New York 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 $141 · 10th–90th $68$4070%10%10th90th$141Professionalmedian $107 · 10th–90th $51$2450%5%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
$67.61 / $141.25 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $120.23 / $281.84
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $109.65 / $144.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $87.10 / $117.49
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $154.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $257.04
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $302.00
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $117.49 / $208.93
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $100.00 / $128.82
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $125.89 / $229.09
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $151.36 / $218.78
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $154.88 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $61.66 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $100.00 / $218.78
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $95.50 / $165.96
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $125.89 / $186.21