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Pennsylvania rates for HCPCS 96165

Health behavior intervention, group (2 or more patients), face-to-face; each additional 15 minutes (List separately in addition to code for primary service)

Facilitymedian $4 · 10th–90th $4–$40%50%90th$4Professionalmedian $4 · 10th–90th $3–$80%20%40%10th90th$4$1.0$5.0$20.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.98 / $7.94
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $5.25 / $7.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $7.24 / $7.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $4.90 / $8.13
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $7.41
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.89 / $3.89 / $4.07
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $5.01 / $9.33
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $8.32 / $14.79
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.98 / $7.94
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $4.07 / $5.13
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.31 / $3.98 / $5.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.58 / $4.37 / $6.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.47 / $4.57 / $7.94