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Behavior Therapy Plan Adjustment by Provider

Iowa rates for HCPCS 97155

This service is a hands-on session where a qualified provider directly works with a patient, most often a child with autism, to observe how a behavior support plan is going and make adjustments in real time. It differs from sessions run by a trained technician because the treating provider is personally present and actively modifying the approach based on what they see.

Rates data updated October 2026.

How much does Behavior Therapy Plan Adjustment by Provider cost?

$39.81

Typical negotiated rate. In Iowa, October 2026.

Insurers have agreed to pay about $39.81 for this service. The price depends on where it is billed: about $39.81 from a physician practice, and about $275 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$39.81$36.31 to $42.66
FacilityA hospital or hospital-owned outpatient department$275$50.12 to $427

How much rates vary

Facilitymedian $275 · 10th to 90th $42 to $490Professionalmedian $40 · 10th to 90th $15 to $46
$20$50$100$200$500facility $275professional $40

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$14.79
Median
$14.79
Typical High
$223.87
Aetna
Setting
Professional
Modifier
None
Typical Low
$14.79
Median
$14.79
Typical High
$14.79
Cigna
Setting
Professional
Modifier
None
Typical Low
$31.62
Median
$42.66
Typical High
$45.71
Hally Health
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$67.61
Typical High
$93.33
Medica
Setting
Facility
Modifier
None
Typical Low
$41.69
Median
$204.17
Typical High
$478.63
Medica
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$177.83
Typical High
$177.83
Medica
Setting
Professional
Modifier
HN · Bachelor's level
Typical Low
$16.60
Median
$16.60
Typical High
$16.60
Medica
Setting
Professional
Modifier
HO · Master's level
Typical Low
$19.50
Median
$19.50
Typical High
$19.50
Medica
Setting
Professional
Modifier
HP · Doctoral level
Typical Low
$19.50
Median
$19.50
Typical High
$19.50
Midlands
Setting
Professional
Modifier
None
Typical Low
$36.31
Median
$36.31
Typical High
$42.66
Midlands
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$50.12
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$29.51
Median
$29.51
Typical High
$58.88
Oscar Health
Setting
Professional
Modifier
HN · Bachelor's level
Typical Low
$16.60
Median
$16.60
Typical High
$16.60
United
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$446.68
Typical High
$562.34
United
Setting
Professional
Modifier
None
Typical Low
$31.62
Median
$52.48
Typical High
$93.33
United
Setting
Professional
Modifier
HN · Bachelor's level
Typical Low
$16.60
Median
$16.60
Typical High
$16.60
United
Setting
Professional
Modifier
HO · Master's level
Typical Low
$19.50
Median
$19.50
Typical High
$19.50
United
Setting
Professional
Modifier
HP · Doctoral level
Typical Low
$19.50
Median
$19.50
Typical High
$19.50
Wellmark
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$39.81
Typical High
$39.81

Where Iowa sits

The same service costs 3.4 times more in Wyoming than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Iowa· 3rd of 51

$39.81

WY $48.98AL $14.45

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.