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Extended Preventive Counseling Visit

Wisconsin 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.

Facilitymedian $83 · 10th–90th $63$1780%10%10th90th$83Professionalmedian $100 · 10th–90th $65$2400%5%10%10th90th$100$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$131.83
Typical High
$223.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$75.86
Typical High
$131.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$120.23
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$269.15
Typical High
$389.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$151.36
Typical High
$245.47
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$83.18
Typical High
$158.49
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$229.09
Medica
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$83.18
Typical High
$165.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$162.18
Typical High
$549.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$33.11
Typical High
$177.83
Network Health
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$144.54
Typical High
$199.53
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$83.18
Typical High
$158.49
Quartz
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$158.49
Typical High
$251.19
Quartz
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$446.68
Quartz
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$186.21
Typical High
$549.54
Security Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$144.54
Security Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$177.83
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$181.97
Typical High
$269.15