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Washington 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 $10 · 10th–90th $6–$270%20%10th90th$10Professionalmedian $14 · 10th–90th $8–$180%50%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
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $14.13 / $18.20
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $3.24 / $3.24
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $14.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.13 / $10.23 / $15.14
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $6.31 / $81.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $6.31 / $10.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $12.59 / $22.91
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $19.50 / $19.50
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $14.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $10.47 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $8.32 / $13.80
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.25 / $10.00