go back

Preventive Visit, Established Patient, Age 65+

Iowa 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?

$170

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $170 for this service. The price depends on where it is billed: about $170 from a physician practice, and about $135 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$170$120 to $245
FacilityA hospital or hospital-owned outpatient department$135$100 to $186

How much rates vary

Facilitymedian $135 · 10th to 90th $81 to $251Professionalmedian $170 · 10th to 90th $93 to $372
$50$100$200$500facility $135professional $170

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$208.93
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$169.82
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$181.97
Typical High
$323.59
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$181.97
Typical High
$302.00
Medica
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$134.90
Typical High
$223.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$194.98
Typical High
$851.14
Midlands
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$199.53
Typical High
$338.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$263.03
Typical High
$354.81
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$194.98
Typical High
$295.12
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$117.49
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$154.88
Typical High
$275.42
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$147.91
Typical High
$234.42

Where Iowa 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.

Iowa· 8th of 51

$170

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.