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New York 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 $155 · 10th–90th $76$4790%10%20%10th90th$155Professionalmedian $145 · 10th–90th $76$3240%10%10th90th$145$0.0$0.2$2.0$20.0$200.0$2.0K

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
$83.18 / $158.49 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $158.49 / $338.84
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $128.82 / $144.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $128.82 / $208.93
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $162.18 / $323.59
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $107.15
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $144.54 / $257.04
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $125.89 / $158.49
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $144.54 / $281.84
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $173.78 / $213.80
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $190.55 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $87.10 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $123.03 / $309.03
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $114.82 / $218.78
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $154.88 / $245.47