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Advance Care Planning Discussion

Florida 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 $93 · 10th–90th $65$1350%20%10th90th$93Professionalmedian $76 · 10th–90th $60$1480%20%40%10th90th$76$0.1$0.5$2.0$10.0$50.0$200.0

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
$64.57
Median
$81.28
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$74.13
Typical High
$144.54
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$85.11
Typical High
$251.19
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$81.28
Typical High
$120.23
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$58.88
Median
$75.86
Typical High
$131.83
AvMed
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$58.88
Typical High
$64.57
AvMed
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$77.62
Typical High
$93.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$100.00
Typical High
$190.55
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$128.82
Typical High
$131.83
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$64.57
Typical High
$102.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$36.31
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$89.13
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$85.11
Typical High
$151.36
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$83.18
Median
$95.50
Typical High
$100.00
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$67.61
Typical High
$87.10