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Behavior Therapy Plan Adjustment by Provider

Wisconsin 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 $21 · 10th–90th $19$400%20%40%10th90th$21Professionalmedian $21 · 10th–90th $19$780%20%40%10th90th$21$20.0$50.0$100.0$200.0

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
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$19.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$19.50
Typical High
$28.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$32.36
Typical High
$102.33
CareSource
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
CareSource
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Cigna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$120.23
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$40.74
Typical High
$61.66
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$18.62
Median
$19.50
Typical High
$31.62
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
Medica
Setting
Facility
Modifier
Global
Typical Low
$18.62
Median
$20.89
Typical High
$31.62
Medica
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$66.07
Typical High
$177.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$54.95
Typical High
$85.11
Network Health
Setting
Facility
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$18.62
Network Health
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$25.12
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$18.62
Median
$19.50
Typical High
$31.62
Quartz
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$56.23
Typical High
$93.33
Quartz
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$154.88
Quartz
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$138.04
Typical High
$173.78
Security Health
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$42.66
Security Health
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$41.69
Typical High
$52.48
United
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$16.60
Typical High
$19.50
United
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$32.36
Typical High
$89.13