PR E&M Preventive Medicine Periodic Comprehensive Established Pt 40-64 Yrs

Payers reporting CPT 99396

Payer pricing summary

Low

$54

Average

$2.5k

Median

$174

High

$45.8k

Payer rate distribution

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#
1	Oscar professional · fee schedule · both · +14 other terms	9	$143	$147	$16	11%	594	$124 – $168
2	Ambetter fee schedule · both · +19 other terms	17	$130	$182	$35	19%	155	$92 – $338
3	Premera professional · fee schedule · both · +9 other terms	14	$145	$147	$19	13%	93–165	$100 – $184
4	Tricare professional · fee schedule · outpatient · +18 other terms	23	$97	$100	$15	15%	87–114	$73 – $131
5	UnitedHealthcare fee schedule · outpatient · +37 other terms	190	$124	$187	$133	71%	80–98	$1 – $746
6	Carefirst professional · fee schedule · both · +11 other terms	15	$132	$124	$39	31%	75–174	$20 – $184
7	Anthem fee schedule · outpatient · +28 other terms	65	$126	$125	$25	20%	44	$20 – $337
8	Ucare professional · fee schedule · outpatient · +12 other terms	24	$131	$120	$33	28%	30–48	$20 – $224
9	Humana fee schedule · outpatient · +26 other terms	233	$118	$189	$582	308%	14–23	$1 – $8.3k
10	Excellus professional · fee schedule · both · +14 other terms	19	$120	$120	$50	41%	5–50	$20 – $326
11	Blue Cross Blue Shield fee schedule · outpatient · +28 other terms	179	$275	$297	$162	55%	4–40	$0 – $719
12	Optum professional · fee schedule · outpatient · +18 other terms	23	$128	$101	$34	34%	4–40	$46 – $134
13	Bcbs Mt fee schedule · outpatient · +1 other terms	1	$296	$296	—	—	2–20	$296 – $296
14	First Health professional · fee schedule · both · +18 other terms	23	$105	$111	$71	64%	1–10	$0 – $363
15	Phcs professional · fee schedule · both · +13 other terms	8	$168	$160	$86	54%	1–10	$0 – $307
16	Bcbs Mo professional · other · both · +2 other terms	1	$168	$168	—	—	1–10	$168 – $168
17	Aetna fee schedule · outpatient · +33 other terms	152	$125	$320	$805	252%	—	$1 – $8.4k
18	Cigna fee schedule · outpatient · +27 other terms	103	$130	$158	$102	65%	—	$0 – $460
19	Molina fee schedule · outpatient · +27 other terms	43	$103	$115	$72	62%	—	$1 – $329
20	Kaiser fee schedule · outpatient · +19 other terms	37	$130	$169	$92	55%	—	$5 – $523
21	Caresource fee schedule · outpatient · +18 other terms	33	$77	$146	$46	31%	—	$1 – $189
22	Medica fee schedule · both · +17 other terms	26	$198	$240	$124	52%	—	$70 – $392
23	MultiPlan fee schedule · outpatient · +19 other terms	26	$143	$185	$137	74%	—	$78 – $594
24	Wellmark fee schedule · both · +19 other terms	25	$159	$162	$9	6%	—	$159 – $208
25	Healthpartners fee schedule · both · +14 other terms	24	$183	$246	$93	38%	—	$88 – $398

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← Hospitals reporting CPT 99396 · Snapshot 20261111T120946Z-9134e7f7