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Maine rates for HCPCS 97157

Multiple-family group adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of guardians/caregivers, each 15 minutes

Facilitymedian $19 · 10th–90th $19–$190%50%100%$19Professionalmedian $19 · 10th–90th $15–$300%20%40%10th90th$19$5.0$10.0$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 / $23.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $7.08 / $13.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $25.70 / $69.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $30.20 / $61.66
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $23.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $30.20 / $50.12