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Nationwide rates for HCPCS 97151

Behavior identification assessment, administered by a physician or other qualified health care professional, each 15 minutes of the physician's or other qualified health care professional's time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan

Facilitymedian $26 · 10th–90th $19–$1070%20%10th90th$26Professionalmedian $19 · 10th–90th $17–$650%20%40%10th90th$19$0.5$5.0$50.0$500.0$5.0K$50.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $56.23 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.05 / $38.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $30.20 / $30.20
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $29.51 / $54.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $35.48 / $83.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $36.31 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $57.54 / $100.00

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