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New Jersey 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 $29 · 10th–90th $19–$3470%20%40%10th90th$29Professionalmedian $19 · 10th–90th $18–$480%20%40%10th90th$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
$19.05 / $28.84 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $25.70
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $22.91 / $24.55
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $56.23 / $56.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $26.30 / $70.79
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $446.68 / $812.83
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $29.51 / $64.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $21.38 / $26.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $35.48 / $61.66