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Missouri 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 $20 · 10th–90th $17–$370%20%10th90th$20Professionalmedian $19 · 10th–90th $17–$850%20%40%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
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $22.39 / $26.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $30.90 / $50.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $21.88 / $40.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $19.95 / $38.02
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $48.98 / $177.83
Qualchoice
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $51.29 / $51.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $21.38 / $35.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $39.81 / $63.10