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Pennsylvania 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 $63 · 10th–90th $56–$2880%20%10th90th$63Professionalmedian $19 · 10th–90th $17–$310%20%40%10th90th$19$1.0$5.0$20.0$100.0$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
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $63.10 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $25.12
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $17.78 / $20.89
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $194.98 / $1,380.38
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $26.92 / $43.65
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.95
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $20.89 / $42.66
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $15.85
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $398.11 / $912.01
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $30.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $19.05 / $25.12
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $19.50
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $16.22
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.93 / $19.95 / $34.67
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $34.67 / $61.66