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Preventive Visit, Established Patient, Age 65+

Kentucky 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?

$120

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $120 for this service. The price depends on where it is billed: about $120 from a physician practice, and about $112 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$120$95.50 to $158
FacilityA hospital or hospital-owned outpatient department$112$91.20 to $120

How much rates vary

Facilitymedian $112 · 10th to 90th $85 to $145Professionalmedian $120 · 10th to 90th $81 to $219
$100$200$500facility $112professional $120

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
$85.11
Median
$91.20
Typical High
$114.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$120.23
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$131.83
Typical High
$173.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$104.71
Typical High
$147.91
CareSource
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$104.71
Typical High
$158.49
CareSource
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$134.90
Typical High
$181.97
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$141.25
Typical High
$676.08
Molina
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$107.15
Typical High
$144.54
United
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$120.23
Typical High
$194.98

Where Kentucky 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.

Kentucky· 43rd of 51

$120

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.