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Wisconsin 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 $21 · 10th–90th $19–$510%20%10th90th$21Professionalmedian $24 · 10th–90th $18–$930%20%10th90th$24$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
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 / $95.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $33.88 / $104.71
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $28.84
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $53.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $120.23 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $40.74 / $61.66
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.50 / $28.84
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $20.42 / $30.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $69.18 / $186.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $54.95 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $21.88
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $30.20
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $41.69 / $74.13
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $181.97
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $131.83 / $181.97
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $51.29 / $64.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $14.79 / $17.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $60.26 / $93.33