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South Dakota 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 $23 · 10th–90th $19–$320%20%40%10th90th$23Professionalmedian $23 · 10th–90th $19–$3630%20%10th90th$23$20.0$50.0$100.0$200.0$500.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $22.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $19.95 / $363.08
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $21.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $32.36 / $40.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.50 / $33.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $74.13 / $177.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $48.98 / $48.98
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $39.81 / $87.10
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81