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Ohio 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 $74 · 10th–90th $45–$1450%20%40%10th90th$74Professionalmedian $148 · 10th–90th $87–$2950%10%10th90th$148$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
$44.67 / $47.86 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $151.36 / $309.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $128.82 / $169.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $138.04 / $213.80
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $165.96 / $234.42
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $102.33 / $151.36
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $131.83 / $257.04
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
$91.20 / $131.83 / $239.88
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $213.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $81.28 / $128.82
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $147.91 / $208.93
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $134.90 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $117.49 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $120.23 / $199.53