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Massachusetts 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 $18 · 10th–90th $12–$710%20%10th90th$18Professionalmedian $14 · 10th–90th $11–$300%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
$18.20 / $18.20 / $18.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.13 / $18.20
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $70.79 / $70.79
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $14.13 / $40.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $15.14 / $70.79
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $13.80 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $12.02 / $16.98
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.41 / $13.80 / $60.26
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $18.62 / $34.67
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $112.20 / $112.20
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $70.79 / $70.79
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $14.13 / $40.74
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $12.59 / $14.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.13 / $10.96 / $35.48