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Extended Preventive Counseling Visit

Massachusetts 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?

$105

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $77.62 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 9 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$105$77.62 to $155
FacilityA hospital or hospital-owned outpatient department$77.62$46.77 to $89.13

How much rates vary

Facilitymedian $78 · 10th to 90th $34 to $129Professionalmedian $105 · 10th to 90th $65 to $204
$50$100$200$500facility $78professional $105

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
$77.62
Median
$89.13
Typical High
$147.91
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$77.62
Typical High
$147.91
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$91.20
Typical High
$446.68
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$109.65
Typical High
$281.84
BCBS
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$186.21
BCBS
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$141.25
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$107.15
Typical High
$186.21
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$56.23
Typical High
$97.72
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$77.62
Typical High
$144.54
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$128.82
Typical High
$218.78
Health New England
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$95.50
Typical High
$138.04
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$91.20
Typical High
$446.68
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$109.65
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$120.23
Typical High
$234.42

Where Massachusetts 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.

Massachusetts· 6th of 51

$105

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.