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New York 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 $178 · 10th–90th $78–$5130%10%10th90th$178Professionalmedian $135 · 10th–90th $58–$3390%10%10th90th$135$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
$85.11 / $181.97 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $154.88 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $125.89 / $147.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $104.71 / $151.36
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $154.88 / $309.03
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $104.71
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $144.54 / $245.47
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $114.82 / $154.88
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $141.25 / $269.15
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $169.82 / $208.93
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $295.12
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $141.25 / $181.97
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $120.23 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $109.65 / $309.03
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $112.20 / $208.93
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $147.91 / $239.88