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Pennsylvania rates for HCPCS G0396

Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes

Facilitymedian $49 · 10th–90th $49–$490%50%100%$49Professionalmedian $31 · 10th–90th $23–$390%20%10th90th$31$1.0$5.0$20.0$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
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $30.90 / $38.90
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $37.15
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $36.31 / $64.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $44.67
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $52.48 / $77.62
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $36.31 / $70.79
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $32.36 / $41.69
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $64.57 / $70.79
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $30.20 / $74.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $38.02 / $64.57