Aetna reimbursement rates in North Carolina
Aetna's median rate for 97153 (one-on-one ABA therapy by a technician) in North Carolina is $15.55 per 15 min, across 52 published rates from 2251 providers. That is 25% below North Carolina Medicaid's fee-for-service rate of $20.81.
- Codes with a median
- 181
- 97153 median
- $15.55per 15 min
- Files
- October 2026
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Aetna vs North Carolina Medicaid
For 97155 (ABA therapy led by the analyst (plan adjusted in session)), the median of Aetna's published North Carolina rates is $20.97 per 15 min (45 rates, 2251 providers). That is 35% below North Carolina Medicaid's fee-for-service rate of $32.22. Aetna publishes North Carolina rates for 181 of the codes we track. Figures are from the October 2026 files.
| Code | Aetna median | Per hour | North Carolina Medicaid | TRICARE | Rates (n) |
|---|---|---|---|---|---|
| 97153One-on-one ABA therapy by a technician | $15.55per 15 min | $62.20 | $20.8125% below | — | 522251 providers |
| 97155ABA therapy led by the analyst (plan adjusted in session) | $20.97per 15 min | $83.88 | $32.2235% below | — | 452251 providers |
All 181 Aetna codes with a median in North Carolina
Frequently asked questions
What does Aetna pay for 97153 in North Carolina?
The median of Aetna's published North Carolina rates for 97153 is $15.55 per 15 min ($62.20 per hour), from 52 rates and 2251 providers in the October 2026 files.
Does Aetna pay more than North Carolina Medicaid for 97153?
Aetna's median is 25% below the Medicaid fee-for-service rate of $20.81 per 15 min.
What does Aetna pay for 97155 in North Carolina?
The median of Aetna's published North Carolina rates for 97155 is $20.97 per 15 min ($83.88 per hour), from 45 rates and 2251 providers in the October 2026 files.
Does Aetna pay more than North Carolina Medicaid for 97155?
Aetna's median is 35% below the Medicaid fee-for-service rate of $32.22 per 15 min.
How many codes does Aetna publish rates for in North Carolina?
181 of the behavioral health, ABA, therapy, home health and other codes we track have a Aetna median in North Carolina. The full list, with ranges and modifier tiers, is in the workspace.