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Preventive Visit, Established Patient, Age 65+

South Carolina 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?

$129

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $129 for this service. The price depends on where it is billed: about $129 from a physician practice, and about $135 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$129$100 to $170
FacilityA hospital or hospital-owned outpatient department$135$107 to $170

How much rates vary

Facilitymedian $135 · 10th to 90th $89 to $219Professionalmedian $129 · 10th to 90th $87 to $245
$100$200$500facility $135professional $129

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$131.83
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$134.90
Typical High
$223.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$93.33
Typical High
$144.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$134.90
Typical High
$239.88
Medcost
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$141.25
Typical High
$173.78
Medcost
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$134.90
Typical High
$218.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$81.28
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$112.20
Typical High
$177.83

Where South Carolina 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.

South Carolina· 30th of 51

$129

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.