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Maine 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 $19 · 10th–90th $19–$190%50%100%$19Professionalmedian $20 · 10th–90th $19–$440%20%10th90th$20$20.0$50.0$100.0$200.0

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
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $19.05 / $25.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $25.12 / $50.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $56.23 / $109.65
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $35.48 / $77.62
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $25.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $54.95 / $91.20