Tynbil: Know the *real* price for healthcare services

New Jersey 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.

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.68 / $73.31 / $78.93	Facility	$65.68	$73.31	$78.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.45 / $67.56 / $82.16	Professional	$57.45	$67.56	$82.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.83 / $101.06 / $156.19	Professional	$55.83	$101.06	$156.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $122.16 / $122.16 / $122.16	Professional	$122.16	$122.16	$122.16
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.89 / $91.64 / $137.09	Professional	$77.89	$91.64	$137.09
United Facility/Professional Professional Modifier Low / Median / High Price $60.17 / $92.46 / $161.44	Professional	$60.17	$92.46	$161.44