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New York 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 $234 · 10th–90th $13$3890%20%10th90th$234Professionalmedian $19 · 10th–90th $7$240%20%10th90th$19$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$23.99 / $234.42 / $389.05
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
$7.41 / $9.55 / $12.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $12.88 / $25.12
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.14
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.31 / $3.31 / $4.90
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.31 / $6.61 / $10.96
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $15.85 / $15.85
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $12.88 / $12.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.62 / $13.80 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $9.12 / $44.67
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.31 / $3.47 / $6.31
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.31 / $6.31 / $10.96