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Vermont 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 $23 · 10th–90th $23–$230%50%100%$23Professionalmedian $19 · 10th–90th $16–$240%20%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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $22.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $19.05 / $23.99
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $15.85 / $15.85
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $8.71 / $25.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $8.71 / $14.79