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New York 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 $234 · 10th–90th $24–$4470%10%10th90th$234Professionalmedian $24 · 10th–90th $18–$600%20%10th90th$24$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$23.99 / $234.42 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $30.90
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $33.88 / $38.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $45.71 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $32.36 / $229.09
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $31.62
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $45.71
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $53.70 / $100.00
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $32.36
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $25.70 / $30.20
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $40.74 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $50.12 / $112.20
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $20.42 / $57.54
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $51.29 / $100.00