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Extended Preventive Counseling Visit

North Carolina 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?

$115

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $115 for this service. The price depends on where it is billed: about $115 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 8 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$115$85.11 to $151
FacilityA hospital or hospital-owned outpatient department$95.50$77.62 to $123

How much rates vary

Facilitymedian $95 · 10th to 90th $68 to $170Professionalmedian $115 · 10th to 90th $72 to $191
$50$100$200facility $95professional $115

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
$114.82
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$79.43
Typical High
$147.91
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$120.23
Typical High
$154.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$120.23
Typical High
$199.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$107.15
Typical High
$177.83
Medcost
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$114.82
Typical High
$162.18
Medcost
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$93.33
Typical High
$151.36
Medcost
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$218.78
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$141.25
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$87.10
Typical High
$147.91
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54

Where North Carolina 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.

North Carolina· 4th of 51

$115

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.