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Montana 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 $33 · 10th–90th $15–$370%20%40%10th90th$33Professionalmedian $17 · 10th–90th $13–$350%20%10th90th$17$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $20.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $64,565.42 / $89,125.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $33.11 / $33.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $33.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $28.18 / $33.88
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $36.31 / $38.02
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $36.31 / $38.02
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $19.05 / $28.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $52.48 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $23.44 / $33.11