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Extended Preventive Counseling Visit

New Jersey 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?

$75.86

Typical physician fee. In New Jersey, October 2026.

Insurers have agreed to pay about $75.86 for this service. Most negotiated rates run $64.57 to $93.33.

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.

How much rates vary

Facilitymedian $65 · 10th to 90th $62 to $76Professionalmedian $76 · 10th to 90th $56 to $115
$100facility $65professional $76

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
Facility
Modifier
None
Typical Low
$61.66
Median
$64.57
Typical High
$75.86
Aetna
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$74.13
Typical High
$81.28
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$30.90
Median
$32.36
Typical High
$38.02
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$9.33
Median
$9.55
Typical High
$11.48
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.17
Median
$6.46
Typical High
$7.59
Ambetter
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$85.11
Typical High
$91.20
AmeriHealth
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$72.44
Typical High
$194.98
Cigna
Setting
Professional
Modifier
None
Typical Low
$52.48
Median
$66.07
Typical High
$117.49
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$131.83
Typical High
$144.54
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$95.50
Typical High
$151.36
United
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$77.62
Typical High
$123.03

Where New Jersey 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.

New Jersey· 44th of 51

$75.86

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.