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Advance Care Planning Discussion

Iowa 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 $81 · 10th–90th $63$1510%10%20%10th90th$81Professionalmedian $87 · 10th–90th $62$2570%10%10th90th$87$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
$74.13
Median
$138.04
Typical High
$151.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$77.62
Typical High
$194.98
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$61.66
Median
$95.50
Typical High
$288.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$138.04
Typical High
$204.17
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$114.82
Typical High
$239.88
Medica
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$75.86
Typical High
$154.88
Medica
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$131.83
Typical High
$524.81
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$102.33
Median
$102.33
Typical High
$151.36
Midlands
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$154.88
Typical High
$199.53
Midlands
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$158.49
Typical High
$223.87
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$120.23
Typical High
$181.97
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$107.15
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$190.55
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$93.33
Typical High
$120.23