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Extended Preventive Counseling Visit

Delaware 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?

$74.13

Typical negotiated rate. In Delaware, October 2026.

Insurers have agreed to pay about $74.13 for this service. The price depends on where it is billed: about $74.13 from a physician practice, and about $77.62 from a hospital or other facility.

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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$74.13$67.61 to $83.18
FacilityA hospital or hospital-owned outpatient department$77.62$64.57 to $240

How much rates vary

Facilitymedian $78 · 10th to 90th $63 to $240Professionalmedian $74 · 10th to 90th $62 to $98
$100$200$500facility $78professional $74

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
Facility
Modifier
None
Typical Low
$63.10
Median
$64.57
Typical High
$91.20
Aetna
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$75.86
Typical High
$89.13
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$31.62
Median
$35.48
Typical High
$38.90
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$9.55
Median
$10.72
Typical High
$11.48
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.31
Median
$7.08
Typical High
$7.76
Cigna
Setting
Facility
Modifier
None
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Cigna
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$81.28
Typical High
$102.33
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$239.88
Median
$239.88
Typical High
$457.09
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$97.72
Typical High
$100.00
United
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$74.13
Typical High
$102.33

Where Delaware 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.

Delaware· 47th of 51

$74.13

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.