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Advance Care Planning Discussion

Illinois 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 $135 · 10th–90th $112$1550%20%40%10th90th$135Professionalmedian $76 · 10th–90th $50$1350%10%20%10th90th$76$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
$112.20
Median
$131.83
Typical High
$151.36
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$134.90
Median
$134.90
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$75.86
Typical High
$134.90
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$63.10
Median
$77.62
Typical High
$147.91
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$74.13
Typical High
$100.00
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$56.23
Median
$72.44
Typical High
$93.33
BCBS
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$177.83
Typical High
$208.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$72.44
Typical High
$95.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$107.15
Typical High
$162.18
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$123.03
Typical High
$251.19
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$93.33
Typical High
$109.65
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$128.82
United
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$123.03
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$107.15
Typical High
$158.49
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$87.10
Median
$100.00
Typical High
$134.90