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Behavior Assessment For A Treatment Plan

Iowa rates for HCPCS 97151

This service involves a qualified professional's time spent assessing a patient's behavior, often in coordination with the patient's family or caregivers, to develop an individualized treatment plan. It includes both direct time with the patient and family, as well as time spent analyzing the information gathered and preparing recommendations.

Rates data updated October 2026.

How much does Behavior Assessment For A Treatment Plan cost?

$43.65

Typical negotiated rate. In Iowa, October 2026.

Insurers have agreed to pay about $43.65 for this service. The price depends on where it is billed: about $43.65 from a physician practice, and about $170 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$43.65$38.02 to $63.10
FacilityA hospital or hospital-owned outpatient department$170$72.44 to $245

How much rates vary

Facilitymedian $170 · 10th to 90th $42 to $282Professionalmedian $44 · 10th to 90th $22 to $81
$20$50$100$200facility $170professional $44

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$21.88
Median
$21.88
Typical High
$223.87
Aetna
Setting
Professional
Modifier
None
Typical Low
$21.88
Median
$21.88
Typical High
$21.88
Cigna
Setting
Professional
Modifier
None
Typical Low
$43.65
Median
$63.10
Typical High
$81.28
Hally Health
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$46.77
Typical High
$85.11
Medica
Setting
Facility
Modifier
None
Typical Low
$41.69
Median
$144.54
Typical High
$275.42
Medica
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$257.04
Typical High
$257.04
Medica
Setting
Professional
Modifier
HN · Bachelor's level
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
Medica
Setting
Professional
Modifier
HO · Master's level
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Medica
Setting
Professional
Modifier
HP · Doctoral level
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Midlands
Setting
Professional
Modifier
None
Typical Low
$53.70
Median
$53.70
Typical High
$63.10
Midlands
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$41.69
Typical High
$70.79
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Oscar Health
Setting
Professional
Modifier
HN · Bachelor's level
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
United
Setting
Facility
Modifier
None
Typical Low
$151.36
Median
$257.04
Typical High
$323.59
United
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$77.62
Typical High
$134.90
United
Setting
Professional
Modifier
HN · Bachelor's level
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
United
Setting
Professional
Modifier
HO · Master's level
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
United
Setting
Professional
Modifier
HP · Doctoral level
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Wellmark
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$38.02
Typical High
$38.02

Where Iowa sits

The same service costs 4.8 times more in Wyoming than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Iowa· 8th of 51

$43.65

WY $70.79WV $14.79

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.