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North Carolina 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 $20 · 10th–90th $11–$260%20%10th90th$20Professionalmedian $9 · 10th–90th $4–$200%10%20%10th90th$9$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
$19.95 / $19.95 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $23.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $5.62 / $11.75
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $12.30 / $15.49
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $19.50 / $25.12
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $8.51 / $8.51
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $11.48 / $11.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $11.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $6.61 / $11.48
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $79.43
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $45.71