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Iowa 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 $30 · 10th–90th $19–$660%20%10th90th$30Professionalmedian $19 · 10th–90th $19–$1070%20%40%90th$19$20.0$50.0$100.0$200.0$500.0

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
$53.70 / $53.70 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $64.57 / $81.28
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $46.77 / $63.10
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.50 / $60.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $89.13 / $257.04
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $60.26 / $72.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $70.79
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $30.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $77.62 / $131.83
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.02 / $38.02