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Extended Substance Use Screening And Counseling

Illinois rates for HCPCS 99409

This is a structured screening for alcohol or drug use paired with a brief counseling conversation about the results, lasting more than thirty minutes. A clinician or trained staff member uses a standardized questionnaire to assess use patterns and then discusses next steps with the patient. The longer time reflects a more in-depth conversation than a brief check-in.

Rates data updated July 2026.

How much does Extended Substance Use Screening And Counseling cost?

$58.88

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $58.88 for this service. The price depends on where it is billed: about $58.88 from a physician practice, and about $52.48 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 7 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$58.88$51.29 to $69.18
FacilityA hospital or hospital-owned outpatient department$52.48$45.71 to $61.66

How much rates vary

Facilitymedian $52 · 10th to 90th $44 to $69Professionalmedian $59 · 10th to 90th $45 to $81
$50.0$100.0$200.0facility $52professional $59

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
$43.65
Median
$52.48
Typical High
$67.61
Aetna
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$57.54
Typical High
$77.62
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$74.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$61.66
Typical High
$81.28
Cigna
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$87.10
Typical High
$125.89
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$79.43
Typical High
$208.93
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$100.00
Typical High
$107.15
United
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$52.48
United
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$72.44
Typical High
$114.82

Where Illinois sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $58.88 · 23rd of 51
VT $69.18AZ $56.23

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.