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Kentucky 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 $8 · 10th–90th $3–$190%20%40%10th90th$8Professionalmedian $19 · 10th–90th $5–$220%20%10th90th$19$5.0$10.0$20.0$50.0

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
$3.16 / $3.16 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $19.05 / $21.88
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $3.80 / $4.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $6.76 / $8.51
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $9.77 / $9.77
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $9.77 / $9.77
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
$12.02 / $25.12 / $25.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $9.33 / $44.67
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $6.17 / $10.72