go back

Pennsylvania rates for HCPCS 99386

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; 40-64 years

Facilitymedian $141 · 10th–90th $89$3020%20%10th90th$141Professionalmedian $170 · 10th–90th $107$3550%10%20%10th90th$170$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$89.13 / $141.25 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $177.83 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $147.91 / $199.53
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $281.84 / $281.84
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $169.82 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $173.78 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $151.36 / $251.19
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $181.97 / $316.23
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $120.23 / $234.42
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $100.00 / $218.78
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $158.49 / $223.87
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $281.84 / $281.84
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $131.83 / $363.08
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $138.04 / $257.04
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $158.49 / $194.98
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $269.15 / $416.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $158.49 / $338.84
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $125.89 / $151.36
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $125.89 / $151.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $144.54 / $239.88