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Florida 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 $3–$2880%20%10th90th$19Professionalmedian $19 · 10th–90th $6–$220%50%10th90th$19$0.1$0.5$2.0$10.0$50.0$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
$3.02 / $19.05 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $22.91
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $4.27 / $4.27
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $5.37 / $5.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $8.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $12.30 / $15.85
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.50 / $6.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $8.71 / $10.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $10.96 / $12.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $7.41 / $14.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $6.31 / $6.31