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Virginia 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 $19–$500%20%40%10th90th$21Professionalmedian $19 · 10th–90th $17–$470%50%10th90th$19$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.05 / $23.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $46.77 / $67.61
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $32.36 / $38.90
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
$19.50 / $27.54 / $40.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $32.36 / $40.74
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.22 / $19.95 / $30.90
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $25.12
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $44.67 / $87,096.36
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $44.67 / $87,096.36
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
$25.12 / $39.81 / $67.61