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Virginia 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–$320%10%10th90th$19Professionalmedian $16 · 10th–90th $13–$240%10%20%10th90th$16$10.0$50.0$200.0$1.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.85 / $15.85
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $20.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $16.22 / $22.39
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $20.42 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $72.44 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $18.62 / $36.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $19.50 / $25.12
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $40.74
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $17.38 / $26.92
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $19.50
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $29.51 / $43.65
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $29.51 / $43.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $20.42 / $20.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $23.44 / $36.31