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Massachusetts rates for HCPCS 99397

Periodic comprehensive preventive medicine reevaluation 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, established patient; 65 years and older

Facilitymedian $105 · 10th–90th $49–$1450%10%20%10th90th$105Professionalmedian $178 · 10th–90th $95–$3470%5%10th90th$178$50.0$100.0$200.0$500.0$1.0K

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
$104.71 / $125.89 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $173.78 / $389.05
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $630.96
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $154.88 / $426.58
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $257.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $154.88 / $295.12
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $75.86 / $134.90
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $229.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $186.21 / $338.84
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $218.78 / $281.84
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $630.96
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $154.88 / $426.58
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $120.23 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $158.49 / $338.84