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Connecticut 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 $100 · 10th–90th $44–$4170%20%10th90th$100Professionalmedian $16 · 10th–90th $13–$280%10%20%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
$19.95 / $104.71 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $25.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $54.95 / $83.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $21.38 / $29.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $30.20 / $61.66
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $40.74 / $44.67
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $23.44 / $40.74