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Extended Preventive Counseling Visit

Utah 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?

$74.13

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $74.13 for this service. The price depends on where it is billed: about $74.13 from a physician practice, and about $89.13 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$74.13$58.88 to $89.13
FacilityA hospital or hospital-owned outpatient department$89.13$77.62 to $117

How much rates vary

Facilitymedian $89 · 10th to 90th $78 to $117Professionalmedian $74 · 10th to 90th $51 to $100
$50$100facility $89professional $74

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
$77.62
Median
$77.62
Typical High
$89.13
Aetna
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$81.28
Typical High
$89.13
Cigna
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$97.72
Typical High
$112.20
Molina
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$56.23
Typical High
$69.18
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$117.49
Typical High
$165.96
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$85.11
Typical High
$100.00
Select Health
Setting
Facility
Modifier
None
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Select Health
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$75.86
Typical High
$91.20
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$109.65
Typical High
$177.83
United
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$83.18
Typical High
$120.23
3 more rates 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
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$37.15
Median
$38.90
Typical High
$44.67
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$11.22
Median
$11.48
Typical High
$13.49
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$7.59
Median
$7.76
Typical High
$8.91

Where Utah 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.

Utah· 46th of 51

$74.13

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.