| Name of Insurance Company Being Graded: | ZIP / Postal Code | First procedure | Amount Reimbursed for this procedure | Second procedure | Amount Reimbursed for this procedure | Third procedure | Amount Reimbursed for this procedure |
|---|---|---|---|---|---|---|---|
| anthem blue cross | 92675 | 96116 | $120.00 | 96121 | $120.00 | ||
| Medicare | 53719 | First evaluation visit | $173.56 | 60 minute therapy session | $146.32 | Family therapy with patient | $98.85 |
| Optum | 60712 | ||||||
| United Health Care | 07740 | 90791 | $139.47 | 90837 | $135.00 | ||
| United Healthcare/Optum | 60622 | 90834 | $125.00 | 90837 | $125.00 | 90853 | $60.00 |
| Name of Insurance Company Being Graded: | ZIP / Postal Code | First procedure | Amount Reimbursed for this procedure | Second procedure | Amount Reimbursed for this procedure | Third procedure | Amount Reimbursed for this procedure |
