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New Jersey 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 $29 · 10th–90th $18–$1950%20%40%10th90th$29Professionalmedian $18 · 10th–90th $15–$250%20%40%10th90th$18$5.0$10.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $28.84 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $18.20 / $23.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.99 / $64.57
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $91.20 / $151.36
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $17.78 / $38.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.76 / $9.12 / $11.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $17.78 / $42.66