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New Jersey 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 $29 · 10th–90th $19–$1950%20%40%10th90th$29Professionalmedian $19 · 10th–90th $4–$230%20%40%10th90th$19$2.0$5.0$10.0$20.0$50.0$100.0$200.0

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 / $28.84 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $23.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $12.30 / $15.14
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $12.02
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $91.20 / $151.36
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $4.79 / $10.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $12.88 / $15.85
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.75 / $11.48