Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month.
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.45 | $74.84 | $115.56 | |
BCBS
| Professional | $75.53 | $84.76 | $130.40 | |
Cigna
| Facility | $116.20 | $116.20 | $155.00 | |
Cigna
| Professional | $87.39 | $113.04 | $195.48 | |
Providence
| Facility | $61.24 | $82.16 | $134.26 | |
Providence
| Professional | $76.41 | $105.80 | $150.91 | |
United
| Professional | $125.33 | $139.79 | $197.63 |