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New York 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 $234 · 10th–90th $23–$3890%20%10th90th$234Professionalmedian $19 · 10th–90th $15–$450%20%40%10th90th$19$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$23.99 / $234.42 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $28.18
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $22.91 / $26.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $16.98 / $23.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $30.90 / $154.88
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $27.54
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $30.90
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $37.15 / $69.18
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $21.88 / $21.88
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $21.38 / $21.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $26.30 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $44.67 / $77.62
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $20.42 / $39.81
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $35.48 / $69.18