go back

Behavior Therapy Plan Adjustment by Provider

South Dakota 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 $23 · 10th–90th $19$320%20%40%10th90th$23Professionalmedian $19 · 10th–90th $19$400%50%10th90th$19$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$23.44
Median
$23.44
Typical High
$23.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$19.50
Typical High
$28.84
Avera
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$21.88
Typical High
$21.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$32.36
Typical High
$40.74
Medica
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$19.50
Typical High
$33.88
Medica
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$74.13
Typical High
$177.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$48.98
Typical High
$48.98
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$33.88
United
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$39.81
Typical High
$74.13
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$39.81
Typical High
$39.81