go back

Pennsylvania rates for HCPCS G0397

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

Facilitymedian $95 · 10th–90th $95–$950%50%100%$95Professionalmedian $65 · 10th–90th $46–$760%20%10th90th$65$1.0$5.0$20.0$100.0$500.0

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
$45.71 / $64.57 / $75.86
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $67.61 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $87.10
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $93.33 / $141.25
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $67.61 / $134.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $64.57 / $79.43
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $117.49 / $138.04
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $64.57 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $72.44 / $123.03