go back

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.

How much does Extended Preventive Counseling Visit cost?

$81.28

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $81.28 for this service. The price depends on where it is billed: about $79.43 from a physician practice, and about $117 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 7 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$79.43$69.18 to $100
FacilityA hospital or hospital-owned outpatient department$117$97.72 to $145

How much rates vary

Facilitymedian $117 · 10th to 90th $91 to $182Professionalmedian $79 · 10th to 90th $65 to $120
$100$200facility $117professional $79

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
$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

Where Illinois sits

The same service costs 2.0 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.

Illinois· 26th of 51

$81.28

MN $151DE $74.13

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.