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Ohio 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 $58–$1620%20%10th90th$85Professionalmedian $123 · 10th–90th $68–$2510%10%10th90th$123$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$57.54 / $93.33 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $123.03 / $263.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $107.15 / $141.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $131.83 / $208.93
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $134.90
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $79.43 / $117.49
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $112.20 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $91.20 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $109.65 / $199.53
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $112.20 / $181.97
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $66.07 / $120.23
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $107.15 / $162.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $102.33 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $95.50 / $162.18