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Montana rates for HCPCS 0373T

Adaptive behavior treatment with protocol modification, each 15 minutes of technicians' time face-to-face with a patient, requiring the following components: administration by the physician or other qualified health care professional who is on site; with the assistance of two or more technicians; for a patient who exhibits destructive behavior; completion in an environment that is customized to the patient's behavior.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.30 / $26.54 / $29.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.73 / $24.14 / $24.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.50 / $20.52 / $51.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.12 / $23.32 / $36.14
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.06 / $15.69 / $25.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.63 / $10.56 / $23.82