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Illinois 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 $56 · 10th–90th $14–$1950%20%40%10th90th$56Professionalmedian $14 · 10th–90th $8–$180%20%10th90th$14$2.0$5.0$10.0$20.0$50.0$100.0$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
$14.13 / $194.98 / $194.98
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
$3.55 / $3.55 / $3.55
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $47.86
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $9.12 / $9.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $7.24 / $7.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $10.00 / $16.60
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $28.84 / $50.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $100.00 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $6.31 / $10.47