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Preventive Visit, Established Patient, Age 65+

Utah 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?

$138

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $138 for this service. The price depends on where it is billed: about $138 from a physician practice, and about $70.79 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$138$112 to $200
FacilityA hospital or hospital-owned outpatient department$70.79$70.79 to $70.79

How much rates vary

Facilitymedian $71 · 10th to 90th $31 to $112Professionalmedian $138 · 10th to 90th $89 to $263
$50$100$200$500facility $71professional $138

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
$30.90
Median
$70.79
Typical High
$91.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$138.04
Typical High
$275.42
Cigna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$138.04
Typical High
$257.04
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$60.26
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$144.54
Typical High
$223.87
Select Health
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Select Health
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$114.82
Typical High
$181.97
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$165.96
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$128.82
Typical High
$213.80

Where Utah 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.

Utah· 19th of 51

$138

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.