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Group Behavior Therapy Session

West Virginia rates for HCPCS 97158

A structured behavior therapy session delivered to several people together rather than one-to-one, most often as part of care for autism and related conditions. Participants practice target skills and behaviors with each other while the therapist guides, prompts and reinforces. Time is counted in short blocks and added up for the session.

Rates data updated July 2026.

How much does Group Behavior Therapy Session cost?

$19.05

Typical negotiated rate. In West Virginia, July 2026.

Insurers have agreed to pay about $19.05 for this service. The price depends on where it is billed: about $19.05 from a physician practice, and about $14.79 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$19.05$17.78 to $19.50
FacilityA hospital or hospital-owned outpatient department$14.79$9.12 to $14.79

How much rates vary

Facilitymedian $15 · 10th to 90th $9 to $15Professionalmedian $19 · 10th to 90th $5 to $22
$5$10$20$50facility $15professional $19

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$14.79
Median
$14.79
Typical High
$14.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$19.05
Typical High
$22.39
CareSource
Setting
Facility
Modifier
Global
Typical Low
$6.46
Median
$6.46
Typical High
$9.77
CareSource
Setting
Professional
Modifier
Global
Typical Low
$9.77
Median
$9.77
Typical High
$9.77
Cigna
Setting
Facility
Modifier
Global
Typical Low
$9.12
Median
$9.12
Typical High
$9.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.25
Median
$27.54
Typical High
$27.54
United
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$6.46
Typical High
$11.22

Where West Virginia sits

The same service costs 2.2 times more in Massachusetts than in Minnesota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

West Virginia· 35th of 51

$19.05

MA $22.39MN $10.00

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.