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South Dakota 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 $15 · 10th–90th $14–$260%20%40%10th90th$15Professionalmedian $17 · 10th–90th $13–$270%10%10th90th$17$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
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $14.13 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $19.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $22.39 / $32.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $19.50 / $33.11
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $134.90 / $138.04
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $32.36 / $38.02
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $26.30
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $27.54 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $22.91 / $41.69
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $31.62 / $33.88