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Extended Preventive Counseling Visit

Connecticut rates for HCPCS 99403

A clinician spends a substantial one-on-one session, roughly 45 minutes, counseling a patient on ways to reduce personal health risks, for example around diet, exercise, or other lifestyle factors, separate from a routine checkup. It is handled as its own visit rather than folded into another type of appointment. This length of session allows more in-depth discussion than a brief counseling conversation.

Rates data updated October 2026.

How much does Extended Preventive Counseling Visit cost?

$102

Typical physician fee. In Connecticut, October 2026.

Insurers have agreed to pay about $102 for this service. Most negotiated rates run $89.13 to $126.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $513 · 10th to 90th $513 to $513Professionalmedian $102 · 10th to 90th $74 to $148
$100$200$500facility $513professional $102

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$89.13
Typical High
$104.71
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$104.71
Typical High
$147.91
Cigna
Setting
Facility
Modifier
None
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
Cigna
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$107.15
Typical High
$138.04
ConnectiCare
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$128.82
Typical High
$138.04
Health New England
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$131.83
Typical High
$138.04
United
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$97.72
Typical High
$162.18
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$32.36
Median
$44.67
Typical High
$52.48
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$9.55
Median
$13.49
Typical High
$15.85
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.46
Median
$8.91
Typical High
$10.47

Where Connecticut sits

The same service costs 2.9 times more in Alaska than in Florida. 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.

Connecticut· 18th of 51

$102

AK $186FL $64.57

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.