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Wisconsin 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 $100 · 10th–90th $58–$2040%10%10th90th$100Professionalmedian $138 · 10th–90th $68–$2950%5%10th90th$138$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
$70.79 / $134.90 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $120.23 / $295.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $138.04 / $251.19
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $89.13 / $128.82
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $338.84 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $177.83 / $316.23
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $93.33 / $190.55
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $194.98 / $295.12
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $95.50 / $199.53
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $199.53 / $691.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $58.88 / $100.00
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $158.49 / $245.47
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $186.21 / $309.03
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $467.74
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $199.53 / $691.83
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $162.18
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $190.55 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $186.21 / $281.84