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Advance Care Planning Discussion

Utah 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 $36$1230%20%10th90th$83Professionalmedian $79 · 10th–90th $58$1700%10%20%10th90th$79$20.0$50.0$100.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$83.18
Typical High
$89.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$77.62
Typical High
$169.82
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$77.62
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$100.00
Typical High
$181.97
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$128.82
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$95.50
Typical High
$134.90
Select Health
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Select Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$85.11
Typical High
$128.82
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$109.65
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$91.20
Typical High
$141.25