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Texas 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 $5–$230%20%10th90th$15Professionalmedian $14 · 10th–90th $11–$170%20%40%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
$17.78 / $107.15 / $128.82
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
$12.59 / $12.59 / $12.59
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $7.94 / $19.05
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $40.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $12.02 / $16.98
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $79.43
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $40.74 / $40.74
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.79 / $14.79 / $19.05
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.13 / $18.20
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $30.20
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $12.02
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.57 / $14.79 / $19.05
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $10.96 / $18.20
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
$3.98 / $5.37 / $9.77
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $4.68 / $7.59