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New York 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 $234 · 10th–90th $13$3890%20%10th90th$234Professionalmedian $14 · 10th–90th $9$190%20%40%10th90th$14$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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 / $234.42 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.13 / $19.05
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $3.55 / $3.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $12.59 / $14.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $7.24 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $14.13 / $21.88
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $8.91 / $12.88
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.31 / $3.31 / $4.27
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.31 / $5.75 / $10.96
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $12.88 / $12.88
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $13.80 / $13.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $14.45 / $93.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.07 / $7.59 / $44.67
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.31 / $3.47 / $5.50
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.31 / $5.50 / $10.96