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Extended Preventive Counseling Visit

Michigan 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?

$79.43

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $79.43 for this service. The price depends on where it is billed: about $79.43 from a physician practice, and about $95.50 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 $95.50
FacilityA hospital or hospital-owned outpatient department$95.50$87.10 to $110

How much rates vary

Facilitymedian $95 · 10th to 90th $76 to $112Professionalmedian $79 · 10th to 90th $62 to $126
$100$200facility $95professional $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
$75.86
Median
$95.50
Typical High
$112.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$75.86
Typical High
$100.00
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$83.18
Typical High
$91.20
BCBS
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
BCBS
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$102.33
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$91.20
Typical High
$190.55
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$93.33
Typical High
$112.20
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$79.43
Typical High
$123.03
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$165.96
Typical High
$302.00
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$95.50
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$91.20
Typical High
$158.49

Where Michigan 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.

Michigan· 32nd of 51

$79.43

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.