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Extended Preventive Counseling Visit

Virginia 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?

$85.11

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $83.18 from a physician practice, and about $93.33 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 8 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$83.18$69.18 to $107
FacilityA hospital or hospital-owned outpatient department$93.33$77.62 to $117

How much rates vary

Facilitymedian $93 · 10th to 90th $68 to $145Professionalmedian $83 · 10th to 90th $63 to $138
$100$200facility $93professional $83

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
$67.61
Median
$69.18
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$75.86
Typical High
$117.49
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$100.00
Typical High
$162.18
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$56.23
Typical High
$77.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$104.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$100.00
Typical High
$158.49
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$97.72
Typical High
$151.36
Medcost
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$114.82
Typical High
$144.54
Medcost
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$95.50
Typical High
$151.36
Medcost
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$87.10
Typical High
$120.23
Sentara
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$95.50
Typical High
$138.04
Sentara
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$112.20
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$69.18
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$91.20
Typical High
$151.36

Where Virginia 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.

Virginia· 20th of 51

$85.11

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.