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Massachusetts 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 $107 · 10th–90th $72–$2450%10%20%10th90th$107Professionalmedian $166 · 10th–90th $93–$3470%5%10th90th$166$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
$100.00 / $123.03 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $162.18 / $380.19
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $117.49 / $602.56
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $151.36 / $407.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $245.47
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $181.97 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $151.36 / $288.40
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $102.33 / $151.36
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $177.83 / $257.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $181.97 / $331.13
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $426.58
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $204.17 / $380.19
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $117.49 / $602.56
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $151.36 / $407.38
Tufts
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $75.86 / $87.10
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $138.04 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $147.91 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $154.88 / $316.23