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Iowa 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 $20 · 10th–90th $9–$660%20%10th90th$20Professionalmedian $19 · 10th–90th $8–$220%50%10th90th$19$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
$53.70 / $53.70 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $19.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $11.22 / $14.13
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $38.02 / $39.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.61 / $19.05 / $27.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $11.22 / $40.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $7.76 / $17.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $7.59 / $17.38
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $31.62 / $39.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $11.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $8.71 / $15.85
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $9.55 / $9.55