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Extended Preventive Counseling Visit

Tennessee 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?

$81.28

Typical physician fee. In Tennessee, October 2026.

Insurers have agreed to pay about $81.28 for this service. Most negotiated rates run $69.18 to $97.72.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $56 · 10th to 90th $56 to $66Professionalmedian $81 · 10th to 90th $65 to $191
$100$200$500facility $56professional $81

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$56.23
Median
$56.23
Typical High
$66.07
Aetna
Setting
Professional
Modifier
None
Typical Low
$56.23
Median
$69.18
Typical High
$91.20
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$28.18
Median
$33.88
Typical High
$43.65
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$8.51
Median
$10.00
Typical High
$12.88
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$5.62
Median
$6.76
Typical High
$8.71
Ambetter
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$83.18
Typical High
$125.89
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$85.11
Typical High
$125.89
Cigna
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$81.28
Typical High
$117.49
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
United
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$83.18
Typical High
$125.89
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$70.79
Median
$70.79
Typical High
$70.79

Where Tennessee 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.

Tennessee· 33rd of 51

$81.28

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.