go back

South 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 $18 · 10th–90th $13–$260%10%10th90th$18Professionalmedian $16 · 10th–90th $13–$230%10%20%10th90th$16$10.0$20.0$50.0$100.0

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
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $20.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $22.39 / $33.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.05 / $25.12
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $18.20 / $25.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $22.39 / $28.18