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Virginia 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–$250%20%10th90th$19Professionalmedian $19 · 10th–90th $8–$290%20%40%10th90th$19$2.0$20.0$200.0$2.0K$20.0K

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
$19.05 / $19.05 / $19.05
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
$7.24 / $30.90 / $44.67
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $32.36 / $38.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $8.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $12.02 / $16.22
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $5.75 / $25.12
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.31 / $19.05 / $25.12
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $8.51 / $8.51
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $7.41 / $87,096.36
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $7.41 / $87,096.36
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
$4.27 / $6.92 / $11.48