go back

Utah 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 $31 · 10th–90th $24–$310%50%10th$31Professionalmedian $18 · 10th–90th $13–$350%10%10th90th$18$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
$23.99 / $30.90 / $30.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $16.98 / $23.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $21.88 / $33.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $47.86
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $24.55 / $33.11
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $21.88 / $24.55
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $27.54 / $42.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $22.91 / $27.54