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Utah 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
$23.95 / $23.95 / $23.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.04 / $23.95 / $36.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.57 / $24.00 / $28.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $80.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.50 / $28.50 / $28.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.12 / $23.82 / $28.36