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Preventive Visit, Established Patient, Age 65+

Washington, DC rates for HCPCS 99397

This is a routine preventive checkup for an established patient age 65 or older, focused on prevention rather than a specific complaint. It typically includes a physical exam, review of medications and chronic conditions, and screening recommendations appropriate for the patient's age.

Rates data updated July 2026.

How much does Preventive Visit, Established Patient, Age 65+ cost?

$107

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $107 for this service. Most negotiated rates run $91.20 to $132.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $129 · 10th to 90th $129 to $129Professionalmedian $107 · 10th to 90th $78 to $178
$100$200facility $129professional $107

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$104.71
Typical High
$144.54
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$79.43
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$131.83
Typical High
$257.04
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$154.88
Typical High
$218.78
United
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$107.15
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$138.04
Typical High
$257.04

Where Washington, DC sits

The same service costs 2.1 times more in Minnesota than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington, DC· 50th of 51

$107

MN $224DE $107

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.