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Extended Preventive Counseling Visit (About An Hour)

North Carolina 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?

$151

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $151 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $126 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$151$110 to $200
FacilityA hospital or hospital-owned outpatient department$126$102 to $166

How much rates vary

Facilitymedian $126 · 10th to 90th $87 to $224Professionalmedian $151 · 10th to 90th $93 to $257
$50$100$200facility $126professional $151

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
$85.11
Median
$165.96
Typical High
$275.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$102.33
Typical High
$218.78
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$158.49
BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$177.83
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$117.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$134.90
Typical High
$223.87
Medcost
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$147.91
Typical High
$208.93
Medcost
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$123.03
Typical High
$194.98
Medcost
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$281.84
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$190.55
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$144.54
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$112.20
Typical High
$194.98
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95

Where North Carolina 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.

North Carolina· 3rd of 51

$151

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.