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Texas 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 $19 · 10th–90th $6–$290%20%10th90th$19Professionalmedian $19 · 10th–90th $6–$230%20%40%10th90th$19$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
$23.44 / $107.15 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $22.91
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
$4.57 / $5.37 / $5.37
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.76 / $6.76 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $12.02 / $15.14
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
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $19.50 / $25.70
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $19.05 / $23.99
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.24 / $2.82 / $30.20
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $6.03 / $6.03
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $19.50 / $25.70
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $12.02 / $15.85
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.77 / $11.48 / $11.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $6.17 / $10.23
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $5.50 / $6.31