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Preventive Visit, Established Patient, Age 65+

West Virginia 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 West Virginia, July 2026.

Insurers have agreed to pay about $138 for this service. The price depends on where it is billed: about $145 from a physician practice, and about $126 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 5 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$145$110 to $209
FacilityA hospital or hospital-owned outpatient department$126$102 to $138

How much rates vary

Facilitymedian $126 · 10th to 90th $49 to $166Professionalmedian $145 · 10th to 90th $89 to $257
$20$50$100$200$500facility $126professional $145

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
$48.98
Median
$128.82
Typical High
$165.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$154.88
Typical High
$257.04
CareSource
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$102.33
Typical High
$125.89
CareSource
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$131.83
Typical High
$181.97
Cigna
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$138.04
Typical High
$676.08
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$154.88
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$120.23
Typical High
$181.97

Where West Virginia 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.

West Virginia· 20th 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.