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North Carolina 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 $21 · 10th–90th $18–$310%20%10th90th$21Professionalmedian $26 · 10th–90th $19–$760%10%10th90th$26$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
$19.95 / $19.95 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $75.86
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.91 / $25.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $32.36 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $25.70 / $53.70
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $20.89 / $29.51
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $25.12
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $19.50 / $19.50
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
$27.54 / $38.90 / $70.79
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $281.84