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Arizona rates for HCPCS 97130

Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient contact; each additional 15 minutes (List separately in addition to code for primary procedure)

Facilitymedian $20 · 10th–90th $15–$480%10%20%10th90th$20Professionalmedian $16 · 10th–90th $13–$280%10%10th90th$16$10.0$20.0$50.0$100.0$200.0

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
$16.98 / $165.96 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $23.99
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $17.78 / $19.50
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $13.49 / $19.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $23.44 / $45.71
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $18.62 / $30.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $23.99 / $138.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $23.44 / $38.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.44 / $43.65