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Maryland 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 $35 · 10th–90th $19–$550%20%10th90th$35Professionalmedian $19 · 10th–90th $17–$280%50%10th90th$19$20.0$50.0$100.0$200.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $23.99
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $32.36 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $29.51 / $42.66
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $33.11 / $39.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $41.69 / $58.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $35.48 / $60.26