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Preventive Visit, Established Patient, Age 65+

Maryland 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?

$126

Typical physician fee. In Maryland, July 2026.

Insurers have agreed to pay about $126 for this service. Most negotiated rates run $95.50 to $182.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $89 · 10th to 90th $62 to $132Professionalmedian $126 · 10th to 90th $81 to $263
$100$200$500facility $89professional $126

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
Professional
Modifier
Global
Typical Low
$83.18
Median
$128.82
Typical High
$275.42
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$79.43
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$131.83
Typical High
$223.87
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$147.91
Typical High
$208.93
United
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$89.13
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$128.82
Typical High
$223.87
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$138.04
Typical High
$204.17

Where Maryland 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.

Maryland· 32nd of 51

$126

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.