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Pennsylvania rates for HCPCS 96121

Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; each additional hour (List separately in addition to code for primary procedure)

Facilitymedian $74 · 10th–90th $66–$870%20%10th90th$74Professionalmedian $76 · 10th–90th $59–$1050%20%10th90th$76$10.0$20.0$50.0$100.0$200.0$500.0$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
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $74.13 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $75.86 / $102.33
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $69.18
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $79.43 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $83.18 / $120.23
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $81.28 / $107.15
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $83.18
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $83.18 / $154.88
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $87.10 / $138.04
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $74.13 / $95.50
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $77.62 / $138.04
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $83.18 / $104.71
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $87.10 / $107.15
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $72.44 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $87.10 / $147.91