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New Hampshire 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
Facility
Modifier
Low / Median / High Price
$28.63 / $28.63 / $28.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.30 / $28.63 / $36.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $25.67 / $32.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.00 / $25.56 / $29.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.91 / $8.69 / $19.50
Optum
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.82 / $26.32 / $29.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.40 / $16.78 / $28.70
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00