go back

North Carolina 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 $19 · 10th–90th $14–$330%20%10th90th$19Professionalmedian $16 · 10th–90th $13–$240%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
$18.62 / $33.11 / $53.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $23.99
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $16.22 / $23.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $19.50 / $43.65
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $18.62 / $25.12
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $19.50
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $31.62 / $34.67
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $22.91 / $38.02
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $169.82