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Vermont 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 $105 · 10th–90th $72–$1740%10%20%10th90th$105Professionalmedian $166 · 10th–90th $83–$2880%10%10th90th$166$100.0$200.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $165.96 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $134.90 / $223.87
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $158.49 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $104.71 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $141.25 / $269.15