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Maine 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 $14–$140%50%100%$14Professionalmedian $14 · 10th–90th $11–$190%20%40%10th90th$14$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $14.13 / $14.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.13 / $18.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $7.59 / $13.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $10.00 / $15.14
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $15.85 / $31.62
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.13 / $18.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $10.96 / $22.39