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Pennsylvania rates for HCPCS 97152

Behavior identification-supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 minutes

Facilitymedian $759 · 10th–90th $21–$7590%50%10th$759Professionalmedian $14 · 10th–90th $13–$240%50%10th90th$14$10.0$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
$104.71 / $758.58 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $14.13 / $19.05
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $25.12
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $14.13 / $14.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $17.78 / $67.61
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $12.02
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
$25.12 / $25.12 / $25.12
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $25.12 / $25.12
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $20.89
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $14.13 / $19.05
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
$7.59 / $7.59 / $7.59
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $22.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $74.13