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Extended Preventive Counseling Visit

Illinois 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 July 2026.

Facilitymedian $117 · 10th–90th $91$1820%20%10th90th$117Professionalmedian $79 · 10th–90th $65$1200%10%10th90th$79$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$117.49
Typical High
$151.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$75.86
Typical High
$114.82
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$83.18
Typical High
$89.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$263.03
Typical High
$302.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$83.18
Typical High
$109.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$141.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$104.71
Typical High
$165.96
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$112.20
Typical High
$213.80
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$87.10
Typical High
$112.20
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$125.89
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$89.13
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$104.71
Typical High
$162.18