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New Jersey 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 $138 · 10th–90th $87–$1860%20%10th90th$138Professionalmedian $145 · 10th–90th $87–$2950%10%10th90th$145$0.0$0.2$2.0$20.0$200.0

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
$87.10 / $138.04 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $144.54 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $131.83 / $186.21
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $169.82 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $120.23 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $144.54 / $251.19
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $158.49 / $275.42
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $123.03 / $234.42