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New York 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 $204 · 10th–90th $18–$3890%20%10th90th$204Professionalmedian $15 · 10th–90th $11–$450%20%40%10th90th$15$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
$18.20 / $234.42 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $107.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $19.95 / $26.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $13.18 / $16.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $20.89 / $154.88
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
$12.02 / $12.02 / $19.05
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $30.90
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $37.15 / $69.18
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $19.05 / $19.95
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $18.62 / $18.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $19.50 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $44.67 / $77.62
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $17.78 / $39.81
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $35.48 / $69.18