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Washington 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 $46 · 10th–90th $30–$830%20%10th90th$46Professionalmedian $20 · 10th–90th $17–$760%20%10th90th$20$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $23.99 / $24.55
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $28.18 / $63.10
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $34.67 / $123.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $32.36 / $74.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $15.85 / $28.84
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $45.71 / $45.71
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $19.50 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $51.29 / $91.20
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $44.67 / $85.11