go back

Nebraska rates for HCPCS 99424

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.

Facilitymedian $110 · 10th–90th $69–$1820%10%20%10th90th$110Professionalmedian $74 · 10th–90th $62–$1410%20%10th90th$74$50.0$100.0$200.0$500.0

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
$75.86 / $134.90 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $72.44 / $81.28
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $204.17
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $245.47
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $117.49 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $162.18 / $194.98
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $81.28 / $134.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $158.49 / $512.86
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $154.88 / $204.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $165.96 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $147.91 / $199.53