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Advance Care Planning Discussion

Virginia 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 $89 · 10th–90th $68$1410%10%10th90th$89Professionalmedian $81 · 10th–90th $62$1410%10%10th90th$81$10.0$50.0$200.0$1.0K

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
$70.79
Median
$79.43
Typical High
$125.89
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$75.86
Typical High
$120.23
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$63.10
Median
$85.11
Typical High
$213.80
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$100.00
Typical High
$158.49
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$64.57
Typical High
$87.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$169.82
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$95.50
Typical High
$134.90
Medcost
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Medcost
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$87.10
Typical High
$141.25
Medcost
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$467.74
Sentara
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$91.20
Typical High
$147.91
Sentara
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$100.00
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$77.62
Typical High
$467.74
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$93.33
Typical High
$158.49
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$83.18
Typical High
$100.00