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Iowa 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 $23 · 10th–90th $14–$680%10%20%10th90th$23Professionalmedian $17 · 10th–90th $13–$330%10%10th90th$17$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
$39.81 / $39.81 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $23.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $26.30 / $48.98
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $23.44 / $66.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $18.20 / $35.48
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $25.70 / $138.04
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $37.15 / $53.70
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.88 / $37.15
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $27.54 / $39.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $20.89 / $41.69
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $29.51 / $31.62