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Extended Preventive Counseling Visit

Indiana 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?

$89.13

Typical negotiated rate. In Indiana, October 2026.

Insurers have agreed to pay about $89.13 for this service. The price depends on where it is billed: about $89.13 from a physician practice, and about $162 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$89.13$74.13 to $107
FacilityA hospital or hospital-owned outpatient department$162$72.44 to $251

How much rates vary

Facilitymedian $162 · 10th to 90th $63 to $2,089Professionalmedian $89 · 10th to 90th $63 to $123
$100$200$500$1K$2Kfacility $162professional $89

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
$57.54
Median
$63.10
Typical High
$74.13
Aetna
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$69.18
Typical High
$79.43
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$30.90
Median
$33.88
Typical High
$39.81
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$9.33
Median
$10.23
Typical High
$12.02
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.31
Median
$6.76
Typical High
$7.94
Ambetter
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$208.93
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$104.71
Typical High
$123.03
CareSource
Setting
Facility
Modifier
None
Typical Low
$64.57
Median
$64.57
Typical High
$72.44
CareSource
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$87.10
Typical High
$117.49
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$181.97
Median
$251.19
Typical High
$2,187.76
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$81.28
Typical High
$123.03
United
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$83.18
Typical High
$112.20

Where Indiana 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.

Indiana· 21st of 51

$89.13

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.