go back

Behavior Therapy Plan Adjustment by Provider

Pennsylvania rates for HCPCS 97155

This service is a hands-on session where a qualified provider directly works with a patient, most often a child with autism, to observe how a behavior support plan is going and make adjustments in real time. It differs from sessions run by a trained technician because the treating provider is personally present and actively modifying the approach based on what they see.

Rates data updated July 2026.

Facilitymedian $33 · 10th–90th $11$450%20%40%10th90th$33Professionalmedian $19 · 10th–90th $18$250%50%10th90th$19$20.0$50.0$100.0$200.0$500.0$1.0K$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
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$33.11
Typical High
$141.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$19.50
Typical High
$24.55
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$22.91
Typical High
$30.90
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$575.44
Typical High
$2,570.40
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$26.30
Typical High
$41.69
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$18.20
Typical High
$50.12
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$19.50
Median
$19.50
Typical High
$20.89
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$20.89
Typical High
$41.69
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$23.44
Median
$23.44
Typical High
$23.44
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$17.78
Typical High
$23.44
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$602.56
Typical High
$2,398.83
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$32.36
Typical High
$34.67
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$19.95
Typical High
$25.12
Optum
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$21.38
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$16.22
Typical High
$21.38
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
United
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$44.67
United
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$36.31
Typical High
$61.66