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Extended Preventive Counseling Visit (About An Hour)

Massachusetts rates for HCPCS 99404

A one-on-one counseling visit focused on preventive health, such as reducing risk factors for future illness or supporting healthier habits, lasting roughly an hour. It is a separate visit from a routine checkup, focused specifically on counseling rather than treating an existing illness.

Rates data updated July 2026.

How much does Extended Preventive Counseling Visit (About An Hour) cost?

$135

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $135 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $102 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 9 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$135$100 to $209
FacilityA hospital or hospital-owned outpatient department$102$61.66 to $115

How much rates vary

Facilitymedian $102 · 10th to 90th $45 to $162Professionalmedian $135 · 10th to 90th $85 to $275
$50$100$200$500$1Kfacility $102professional $135

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
$102.33
Median
$114.82
Typical High
$114.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$100.00
Typical High
$257.04
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$123.03
Typical High
$602.56
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$144.54
Typical High
$354.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$251.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$190.55
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$131.83
Typical High
$239.88
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$74.13
Typical High
$131.83
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$100.00
Typical High
$186.21
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$169.82
Typical High
$281.84
Health New England
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$141.25
Typical High
$177.83
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$123.03
Typical High
$602.56
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$144.54
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$154.88
Typical High
$302.00

Where Massachusetts sits

The same service costs 2.1 times more in Minnesota than in Maryland. 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.

Massachusetts· 7th of 51

$135

MN $200MD $95.50

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.