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Wisconsin 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–$440%10%20%10th90th$19Professionalmedian $19 · 10th–90th $13–$500%10%10th90th$19$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
$16.98 / $16.98 / $81.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $20.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $25.12 / $66.07
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $25.12 / $38.02
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $28.18 / $47.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $66.07 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $35.48 / $64.57
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $18.62 / $26.30
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $40.74 / $58.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $19.05 / $27.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $30.20 / $138.04
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $22.39 / $40.74
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $33.11 / $58.88
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $134.90
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $112.20 / $138.04
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $27.54
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $47.86 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $22.91 / $54.95