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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 July 2026.

How much does Extended Preventive Counseling Visit cost?

$93.33

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $93.33 for this service. Most negotiated rates run $74.13 to $135.

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 $195 · 10th to 90th $166 to $195Professionalmedian $93 · 10th to 90th $65 to $191
$100$200facility $195professional $93

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
$72.44
Median
$194.98
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$75.86
Typical High
$123.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$97.72
Typical High
$181.97
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$102.33
Typical High
$181.97
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$125.89
Typical High
$218.78
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$194.98
Typical High
$194.98
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$85.11
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$114.82
Typical High
$177.83

Where Maine 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.

Maine· 12th of 51

$93.33

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.