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Tennessee 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 $15 · 10th–90th $7–$710%20%40%10th90th$15Professionalmedian $19 · 10th–90th $10–$200%50%10th90th$19$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
$15.14 / $15.14 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $19.95
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $4.27 / $4.27
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $6.03 / $10.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $12.30 / $16.22
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $79.43
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $45.71 / $45.71
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $11.48 / $11.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.46 / $8.51 / $18.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $6.46 / $10.72