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Colorado 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 $20–$790%50%90th$20Professionalmedian $16 · 10th–90th $13–$250%10%20%10th90th$16$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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
$19.95 / $19.95 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $21.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $22.39 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $64.57 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $15.49 / $39.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $61.66 / $77.62
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $20.89 / $22.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $23.44 / $47.86