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Extended Preventive Counseling Visit (About An Hour)

Ohio 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?

$105

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $105 for this service. The price depends on where it is billed: about $105 from a physician practice, and about $85.11 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$105$89.13 to $126
FacilityA hospital or hospital-owned outpatient department$85.11$75.86 to $135

How much rates vary

Facilitymedian $85 · 10th to 90th $74 to $148Professionalmedian $105 · 10th to 90th $81 to $166
$100$200facility $85professional $105

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
$74.13
Median
$85.11
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$95.50
Typical High
$141.25
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$89.13
Typical High
$107.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$114.82
Typical High
$181.97
CareSource
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$91.20
Typical High
$117.49
CareSource
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$112.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$117.49
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$123.03
Typical High
$213.80
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$120.23
Typical High
$204.17
Molina
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$102.33
Typical High
$134.90
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$114.82
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$109.65
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$114.82
Typical High
$190.55

Where Ohio 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.

Ohio· 28th of 51

$105

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.