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Utah 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 $16 · 10th–90th $11–$160%50%10th$16Professionalmedian $19 · 10th–90th $12–$240%20%40%10th90th$19$5.0$10.0$20.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
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
$8.32 / $12.02 / $15.14
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.59 / $12.59
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $17.38 / $22.91
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
$4.57 / $6.92 / $13.80