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Advance Care Planning Discussion

West 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 $95 · 10th–90th $65$2750%20%40%10th90th$95Professionalmedian $71 · 10th–90th $59$1580%10%20%10th90th$71$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$69.18
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$251.19
Median
$275.42
Typical High
$275.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$70.79
Typical High
$147.91
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$60.26
Median
$74.13
Typical High
$162.18
CareSource
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$77.62
Typical High
$97.72
CareSource
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$81.28
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$93.33
Typical High
$416.87
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$114.82
Typical High
$123.03
Highmark BCBS
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$67.61
Median
$70.79
Typical High
$117.49
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$123.03
Typical High
$181.97
United
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$89.13
Typical High
$134.90
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$95.50
Median
$95.50
Typical High
$100.00