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California rates for HCPCS 97154

Group adaptive behavior treatment by protocol, administered by technician under the direction of a physician or other qualified health care professional, face-to-face with two or more patients, each 15 minutes

Facilitymedian $14 · 10th–90th $6$220%10%20%10th90th$14Professionalmedian $14 · 10th–90th $8$200%20%10th90th$14$2.0$10.0$50.0$200.0

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
$18.20 / $18.20 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.13 / $18.20
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $3.55 / $3.55
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $12.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $12.02 / $85.11
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $13.49 / $18.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $20.89 / $30.90
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $79.43 / $79.43
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $40.74
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $16.60
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.13 / $14.45 / $20.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $14.13 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.37 / $5.37 / $5.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $5.50 / $13.80