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Pennsylvania 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 $195 · 10th–90th $85–$4570%20%10th90th$195Professionalmedian $15 · 10th–90th $13–$1070%20%40%10th90th$15$10.0$50.0$200.0$1.0K$5.0K

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
$85.11 / $194.98 / $457.09
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 / $19.95 / $26.30
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $645.65 / $3,801.89
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
$52.48 / $52.48 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $16.22 / $41.69
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
$19.50 / $19.50 / $20.89
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $20.89 / $42.66
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $17.78 / $23.44
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $1,096.48 / $3,801.89
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $25.70
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $19.05
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $18.62 / $18.62
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
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
$22.39 / $33.88 / $58.88