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Extended Preventive Counseling Visit

Ohio 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 Ohio, 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 $89.13 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 9 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$67.61 to $97.72
FacilityA hospital or hospital-owned outpatient department$89.13$61.66 to $105

How much rates vary

Facilitymedian $89 · 10th to 90th $56 to $132Professionalmedian $79 · 10th to 90th $60 to $129
$100$200facility $89professional $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
$56.23
Median
$89.13
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$72.44
Typical High
$109.65
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$85.11
Typical High
$100.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$89.13
Typical High
$138.04
CareSource
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$67.61
Typical High
$87.10
CareSource
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$83.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$87.10
Typical High
$91.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$97.72
Typical High
$165.96
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$93.33
Typical High
$158.49
Molina
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$64.57
Typical High
$97.72
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$89.13
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$85.11
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$89.13
Typical High
$147.91

Where Ohio 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.

Ohio· 28th 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.