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Extended Preventive Counseling Visit

Vermont 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?

$97.72

Typical physician fee. In Vermont, October 2026.

Insurers have agreed to pay about $97.72 for this service. Most negotiated rates run $87.10 to $120.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $98 · 10th to 90th $72 to $155
$100$200professional $98

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$89.13
Typical High
$104.71
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$34.67
Median
$44.67
Typical High
$52.48
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$10.47
Median
$13.18
Typical High
$15.49
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$6.92
Median
$8.91
Typical High
$10.47
BCBS Vermont
Setting
Professional
Modifier
None
Typical Low
$147.91
Median
$173.78
Typical High
$173.78
Cigna
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$89.13
Typical High
$102.33
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$102.33
Typical High
$134.90
United
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$104.71
Typical High
$134.90

Where Vermont 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.

Vermont· 20th of 51

$97.72

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.