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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.

Facilitymedian $89 · 10th–90th $56$1320%20%10th90th$89Professionalmedian $79 · 10th–90th $60$1290%20%10th90th$79$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

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