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Extended Preventive Counseling Visit

Maine 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?

$87.10

Typical physician fee. In Maine, October 2026.

Insurers have agreed to pay about $87.10 for this service. Most negotiated rates run $72.44 to $107.

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

Facilitymedian $60 · 10th to 90th $60 to $72Professionalmedian $87 · 10th to 90th $60 to $138
$50$100$200facility $60professional $87

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
$60.26
Median
$60.26
Typical High
$72.44
Aetna
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$72.44
Typical High
$125.89
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$30.20
Median
$36.31
Typical High
$36.31
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$9.12
Median
$10.72
Typical High
$10.72
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.03
Median
$7.24
Typical High
$7.24
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$97.72
Typical High
$158.49
Cigna
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$97.72
Typical High
$138.04
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$100.00
Typical High
$144.54
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$72.44
Typical High
$125.89
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$30.20
Median
$36.31
Typical High
$36.31
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$9.12
Median
$10.72
Typical High
$10.72
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.03
Median
$7.24
Typical High
$7.24
United
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$91.20
Typical High
$138.04

Where Maine 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.

Maine· 24th of 51

$87.10

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.