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Maryland 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 $16–$450%20%10th90th$23Professionalmedian $16 · 10th–90th $13–$250%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
$15.85 / $15.85 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $21.88
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $20.42 / $24.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $19.50 / $47.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $19.50 / $25.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $23.44 / $38.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $24.55 / $37.15
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $21.88 / $32.36