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Nationwide rates for HCPCS 97155

Adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes

Facilitymedian $25 · 10th–90th $18$890%20%10th90th$25Professionalmedian $19 · 10th–90th $17$580%20%40%10th90th$19$0.2$2.0$20.0$200.0$2.0K$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
$18.62 / $31.62 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.05 / $31.62
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $33.88 / $33.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $21.38 / $47.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $29.51 / $53.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $26.92 / $58.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $39.81 / $69.18