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Extended Preventive Counseling Visit

Montana 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?

$112

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $112 for this service. The price depends on where it is billed: about $112 from a physician practice, and about $117 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$112$95.50 to $135
FacilityA hospital or hospital-owned outpatient department$117$107 to $151

How much rates vary

Facilitymedian $117 · 10th to 90th $105 to $162Professionalmedian $112 · 10th to 90th $79 to $141
$100facility $117professional $112

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$83.18
Typical High
$120.23
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$114.82
Typical High
$134.90
Cigna
Setting
Facility
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$162.18
Cigna
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$112.20
Typical High
$134.90
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$104.71
Median
$120.23
Typical High
$162.18
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$112.20
Typical High
$162.18
Providence
Setting
Facility
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$162.18
Providence
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$102.33
Typical High
$138.04
United
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$128.82
Typical High
$154.88
3 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$29.51
Median
$38.90
Typical High
$60.26
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$8.91
Median
$11.48
Typical High
$18.20
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$5.89
Median
$7.76
Typical High
$12.02

Where Montana 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.

Montana· 14th of 51

$112

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.