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Maine rates for HCPCS 97156

Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), each 15 minutes

Facilitymedian $19 · 10th–90th $19–$190%50%100%$19Professionalmedian $20 · 10th–90th $19–$400%20%10th90th$20$20.0$50.0$100.0

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
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $25.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $22.39 / $32.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $39.81 / $79.43
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $35.48 / $72.44
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $25.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $38.02 / $64.57