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Maryland 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 $12 · 10th–90th $6–$190%20%10th90th$12Professionalmedian $19 · 10th–90th $8–$240%20%40%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
$19.05 / $19.05 / $19.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $23.99
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $32.36 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $12.02 / $15.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.17 / $6.03 / $8.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $8.32 / $18.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.07 / $5.89 / $11.22