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Michigan 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–$270%50%90th$19Professionalmedian $19 · 10th–90th $14–$240%20%40%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
$19.05 / $19.05 / $19.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $23.99
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $4.27 / $4.27
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $23.99 / $30.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $26.92 / $30.90
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $26.92
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $12.30 / $15.85
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $30.90
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $30.90
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.88 / $15.85
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $12.59 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.13 / $6.31 / $9.12