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Preventive Visit, Established Patient, Age 65+

Illinois 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?

$135

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $135 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $158 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 7 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$135$105 to $178
FacilityA hospital or hospital-owned outpatient department$158$123 to $209

How much rates vary

Facilitymedian $158 · 10th to 90th $87 to $282Professionalmedian $135 · 10th to 90th $89 to $224
$100$200$500$1Kfacility $158professional $135

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
$87.10
Median
$158.49
Typical High
$263.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$131.83
Typical High
$251.19
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$134.90
Typical High
$190.55
BCBS
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$389.05
Typical High
$457.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$128.82
Typical High
$173.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$151.36
Typical High
$245.47
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$177.83
Typical High
$331.13
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$123.03
Typical High
$177.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$85.11
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$141.25
Typical High
$251.19

Where Illinois 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.

Illinois· 25th of 51

$135

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.