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Pennsylvania 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 $23 · 10th–90th $19–$1410%20%40%10th90th$23Professionalmedian $19 · 10th–90th $15–$240%20%40%10th90th$19$2.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $141.25 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.05 / $23.99
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
$70.79 / $70.79 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $22.91 / $38.02
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 / $20.42 / $35.48
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $6.31 / $6.31
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
$16.98 / $19.05 / $23.99
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $9.12 / $9.12
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $9.12 / $16.22
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.86 / $1.86 / $10.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $14.13 / $46.77