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Virginia 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 $21 · 10th–90th $16–$710%20%10th90th$21Professionalmedian $19 · 10th–90th $17–$510%20%40%10th90th$19$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.05 / $25.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $46.77 / $67.61
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $43.65 / $52.48
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
$21.88 / $28.84 / $69.18
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $46.77 / $60.26
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $20.89 / $40.74
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $25.12
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $58.88 / $83,176.38
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $58.88 / $83,176.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $30.20 / $30.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $58.88 / $100.00