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California 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 $19–$450%10%20%10th90th$25Professionalmedian $21 · 10th–90th $17–$1200%20%10th90th$21$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$23.99 / $23.99 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $89.13
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $23.44 / $26.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $33.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $34.67 / $239.88
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.12 / $61.66
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $36.31 / $38.02
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $281.84 / $281.84
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $37.15
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $24.55 / $43.65
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.70 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $38.02 / $83.18