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97154 · Pennsylvania · every payer

What every payer pays for 97154 in Pennsylvania

Across 6 commercial payers in Pennsylvania, the middle payer's median for 97154 (group ABA therapy by a technician) is $8.20 per 15 min. Pennsylvania Medicaid's fee-for-service rate, $8.15 per 15 min, is 0.6% below that commercial median.

Updated 2026-10-08October 2026 filesSources: state fee schedule, CMS, price-transparency files

Open the payer mixPennsylvania Medicaid rates
Commercial median
$8.20per 15 min
Pennsylvania Medicaid
$8.15
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Payer mix

97154 in Pennsylvania, by payer type

Pennsylvania Medicaid$8.15
Commercial (6 payers)$8.20
UnitedHealthcare$5.05
Horizon BCBS NJ$4.22
per 15 min. Commercial = median of payer medians, October 2026 files.
By payer

Each payer's 97154 rate in Pennsylvania

PayerMedianPer hourRates (n)
UnitedHealthcareCommercial$5.05 per 15 min$20.20189
Horizon BCBS NJCommercial$4.22 per 15 min$16.8847
See every payer's 97154 rate in Pennsylvania

Each commercial payer's median, p25–p75 and n, with Medicaid plan and Medicare Advantage rows. 7-day free trial.

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FAQ

Frequently asked questions

What do commercial payers pay for 97154 in Pennsylvania?

The median of 6 payers' medians is $8.20 per 15 min, from 318 published rates in the October 2026 files.

How does Pennsylvania Medicaid compare with commercial insurance for 97154?

Pennsylvania Medicaid pays $8.15 per 15 min, 0.6% below the commercial median.

What does UnitedHealthcare pay for 97154 in Pennsylvania?

UnitedHealthcare's median is $5.05 per 15 min, from 189 rates and 379 providers.

What does Horizon BCBS NJ pay for 97154 in Pennsylvania?

Horizon BCBS NJ's median is $4.22 per 15 min, from 47 rates and 195 providers.

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