go back

Ohio 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 $95 · 10th–90th $47–$1740%20%10th90th$95Professionalmedian $145 · 10th–90th $89–$2880%10%20%10th90th$145$0.1$0.5$2.0$10.0$50.0$200.0$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
$46.77 / $75.86 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $154.88 / $309.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $134.90 / $173.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $117.49 / $186.21
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $144.54 / $213.80
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $107.15 / $158.49
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $138.04 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $138.04 / $251.19
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $144.54 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $83.18 / $125.89
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $117.49 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $123.03 / $204.17