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Illinois rates for HCPCS 99385

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; 18-39 years

Facilitymedian $145 · 10th–90th $83–$2140%10%20%10th90th$145Professionalmedian $145 · 10th–90th $91–$3020%5%10%10th90th$145$50.0$100.0$200.0$500.0$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
$83.18 / $144.54 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $158.49 / $331.13
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $131.83 / $177.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $371.54 / $426.58
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $134.90 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $144.54 / $239.88
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $169.82 / $323.59
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $117.49 / $173.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $66.07 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $125.89 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $134.90 / $239.88