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Texas 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 $21 · 10th–90th $18–$410%20%10th90th$21Professionalmedian $19 · 10th–90th $17–$290%20%40%10th90th$19$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$23.44 / $107.15 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $26.30
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.99 / $30.20
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $44.67 / $83.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $25.12 / $30.20
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $24.55 / $38.02
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $173.78 / $281.84
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $20.42 / $33.11
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.05 / $25.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.12 / $30.20
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $19.50
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $20.89 / $34.67
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $25.70 / $51.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $19.50 / $19.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $38.02 / $60.26
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $33.11 / $39.81