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Extended Preventive Counseling Visit

Hawaii 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?

$100

Typical physician fee. In Hawaii, October 2026.

Insurers have agreed to pay about $100 for this service. Most negotiated rates run $79.43 to $112.

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

Professionalmedian $100 · 10th to 90th $79 to $151
$100professional $100

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$77.62
Typical High
$109.65
Cigna
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$93.33
Typical High
$147.91
HMSA
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$102.33
Typical High
$114.82
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
United
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$151.36
Typical High
$151.36
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$58.88
Median
$79.43
Typical High
$79.43
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
$29.51
Median
$36.31
Typical High
$50.12
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$8.91
Median
$10.96
Typical High
$14.79
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$5.89
Median
$7.24
Typical High
$10.00

Where Hawaii 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.

Hawaii· 19th of 51

$100

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.