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North Carolina rates for HCPCS 97153

Adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with one patient, each 15 minutes

Facilitymedian $15 · 10th–90th $13–$260%20%40%10th90th$15Professionalmedian $26 · 10th–90th $14–$780%10%20%10th90th$26$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$15.14 / $15.14 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $22.91 / $25.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $32.36 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $15.49 / $53.70
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $15.49 / $23.99
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $16.60 / $16.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $14.13 / $16.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $38.02 / $70.79
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $281.84