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Pennsylvania 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 $100 · 10th–90th $66–$6170%20%10th90th$100Professionalmedian $19 · 10th–90th $17–$390%50%10th90th$19$1.0$5.0$20.0$100.0$500.0$2.0K

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
$66.07 / $141.25 / $616.60
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 / $26.30
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $575.44 / $2,570.40
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $26.30 / $41.69
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $20.89
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $20.89 / $41.69
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $23.44 / $23.44
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $22.39 / $23.44
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $602.56 / $2,398.83
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $30.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $19.05 / $25.12
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $21.38
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $16.22
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.93 / $19.95 / $34.67
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $36.31 / $58.88