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California 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 $7–$300%10%10th90th$19Professionalmedian $19 · 10th–90th $6–$240%20%10th90th$19$5.0$10.0$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
$23.99 / $23.99 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $23.99
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $4.27 / $4.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $7.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $7.94 / $53.70
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $13.18 / $16.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $25.12 / $40.74
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $79.43 / $79.43
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $45.71 / $45.71
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $20.89 / $20.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.31 / $19.50 / $28.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $13.80 / $42.66
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $6.17 / $6.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $6.31 / $15.85