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Pennsylvania 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 $209 · 10th–90th $56–$6030%20%10th90th$209Professionalmedian $19 · 10th–90th $17–$430%50%10th90th$19$1.0$5.0$20.0$100.0$500.0$2.0K

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
$56.23 / $208.93 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $28.18
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $30.20 / $37.15
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $3,715.35
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $32.36 / $69.18
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $22.39
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $22.91 / $47.86
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $24.55 / $24.55
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $512.86 / $4,677.35
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $30.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $19.05 / $25.12
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $33.11
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.93 / $19.95 / $34.67
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $52.48 / $89.13