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Extended Preventive Counseling Visit

South Dakota 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?

$89.13

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $89.13 for this service. The price depends on where it is billed: about $89.13 from a physician practice, and about $100 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 7 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$89.13$74.13 to $138
FacilityA hospital or hospital-owned outpatient department$100$75.86 to $132

How much rates vary

Facilitymedian $100 · 10th to 90th $65 to $155Professionalmedian $89 · 10th to 90th $63 to $174
$100$200$500facility $100professional $89

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
$74.13
Median
$74.13
Typical High
$89.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$75.86
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$131.83
Typical High
$190.55
Medica
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$102.33
Typical High
$158.49
Medica
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$144.54
Typical High
$549.54
Midlands
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$144.54
Typical High
$173.78
Midlands
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$114.82
Typical High
$190.55
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$120.23
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$112.20
Typical High
$173.78
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$107.15
Typical High
$154.88

Where South Dakota 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.

South Dakota· 16th of 51

$89.13

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.