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Ohio 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 $9 · 10th–90th $2–$90%50%10th$9Professionalmedian $11 · 10th–90th $3–$170%20%10th90th$11$0.1$0.5$2.0$10.0$50.0$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
$2.00 / $8.32 / $8.32
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.75 / $14.13 / $18.20
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
$4.07 / $5.62 / $10.47
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.89 / $8.51 / $8.51
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $8.51 / $8.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $7.24 / $15.85
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $7.24 / $7.24
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $10.00 / $17.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $50.12 / $60.26
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $60.26 / $75.86
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
$3.80 / $5.75 / $10.00