go back

North Carolina 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 $15 · 10th–90th $10–$190%20%40%10th90th$15Professionalmedian $8 · 10th–90th $4–$150%10%20%10th90th$8$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
$15.14 / $15.14 / $144.54
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
Professional
Modifier
Typical Low / Median / Typical High
$3.31 / $4.37 / $10.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $12.88 / $18.20
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $14.79 / $19.05
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $12.30 / $12.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $10.47 / $12.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.17 / $5.75 / $12.02
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $79.43
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $40.74