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Pennsylvania rates for HCPCS 96113

Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; each additional 30 minutes (List separately in addition to code for primary procedure)

Professionalmedian $56 · 10th–90th $46–$780%10%20%10th90th$56$10.0$50.0$200.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $56.23 / $77.62
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $85.11
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $46.77 / $50.12
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $69.18 / $112.20
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $44.67 / $83.18
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $61.66 / $112.20
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $66.07 / $1,047.13
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $50.12 / $50.12
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $58.88 / $87.10
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $97.72
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $61.66 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $64.57 / $112.20