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Maine 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 $19–$190%50%100%$19Professionalmedian $19 · 10th–90th $10–$300%20%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. Small sample — interpret with caution. 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
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $6.31 / $14.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $12.02 / $15.14
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $30.20 / $58.88
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.05 / $23.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $10.00 / $39.81