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Illinois 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 $100 · 10th–90th $19–$1950%20%40%10th90th$100Professionalmedian $19 · 10th–90th $15–$240%20%40%10th90th$19$5.0$10.0$20.0$50.0$100.0$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
$19.05 / $194.98 / $194.98
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
$47.86 / $48.98 / $48.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $22.91
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
$6.03 / $11.22 / $15.14
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $37.15 / $52.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $100.00 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.13 / $7.24 / $11.75