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Advance Care Planning Discussion

Arizona rates for HCPCS 99497

A face-to-face conversation between a clinician and a patient, a family member or a person appointed to decide on their behalf, about the patient's wishes for future medical care. It covers explaining and discussing advance directives such as a living will or naming a healthcare proxy, and completing those forms if the patient wishes. It covers the first substantial block of time spent on the discussion.

Rates data updated July 2026.

Facilitymedian $76 · 10th–90th $58$1410%10%10th90th$76Professionalmedian $78 · 10th–90th $60$1780%10%20%10th90th$78$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
$63.10
Median
$89.13
Typical High
$89.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$75.86
Typical High
$144.54
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$85.11
Typical High
$263.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$69.18
Typical High
$89.13
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$54.95
Median
$70.79
Typical High
$93.33
BCBS
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$52.48
Typical High
$257.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$70.79
Typical High
$109.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$97.72
Typical High
$186.21
Medica
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$75.86
Typical High
$134.90
Medica
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$107.15
Typical High
$524.81
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$72.44
Median
$75.86
Typical High
$173.78
United
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$66.07
Typical High
$123.03
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$89.13
Typical High
$154.88
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$75.86
Median
$100.00
Typical High
$100.00