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Nationwide rates for HCPCS 97158

Group adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, face-to-face with multiple patients, each 15 minutes

Facilitymedian $19 · 10th–90th $6$320%20%40%10th90th$19Professionalmedian $19 · 10th–90th $6$240%50%10th90th$19$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$9.33 / $19.95 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $23.99
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $7.41 / $7.41
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $7.08 / $25.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $45.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $12.02 / $16.22
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $9.77 / $19.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $7.08 / $14.13