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Wisconsin 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 $120 · 10th–90th $76–$2570%10%10th90th$120Professionalmedian $182 · 10th–90th $89–$3890%5%10th90th$182$1.0$5.0$20.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $173.78 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $165.96 / $389.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $302.00
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $114.82 / $165.96
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $154.88 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $407.38 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $218.78 / $371.54
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $114.82 / $223.87
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $346.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $117.49 / $239.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $245.47 / $812.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $64.57 / $169.82
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $204.17 / $288.40
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $234.42 / $380.19
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $602.56
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $251.19 / $812.83
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $218.78
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $257.04 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $257.04 / $398.11