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Iowa 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 $27 · 10th–90th $19–$660%20%10th90th$27Professionalmedian $19 · 10th–90th $19–$1410%20%40%90th$19$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
$53.70 / $53.70 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $36.31 / $47.86
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $67.61 / $79.43
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.50 / $41.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $61.66 / $177.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $48.98 / $50.12
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $50.12
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $48.98 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $19.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $52.48 / $89.13
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $39.81 / $39.81