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Advance Care Planning Discussion

South Carolina 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 $83 · 10th–90th $63$1410%10%20%10th90th$83Professionalmedian $74 · 10th–90th $59$1480%10%20%10th90th$74$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
Professional
Modifier
Global
Typical Low
$60.26
Median
$74.13
Typical High
$141.25
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$58.88
Median
$72.44
Typical High
$169.82
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$83.18
Typical High
$120.23
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$85.11
Typical High
$131.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$169.82
Medcost
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$83.18
Typical High
$141.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$181.97
United
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$83.18
Typical High
$125.89