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Ohio 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 $9 · 10th–90th $3–$90%50%10th$9Professionalmedian $16 · 10th–90th $4–$220%20%10th90th$16$0.1$0.5$2.0$10.0$50.0

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
$3.02 / $9.33 / $9.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.16 / $19.05 / $22.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.07 / $5.62 / $17.38
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $9.77 / $9.77
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $9.77
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $8.32 / $15.14
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $8.32
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $8.32 / $15.14
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $50.12 / $60.26
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $60.26 / $75.86
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
$4.37 / $6.61 / $11.48