Tynbil: Know the *real* price for healthcare services

Nationwide rates for HCPCS 99425

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; each additional 30 minutes provided personally by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.46 / $53.07 / $66.81	Facility	$49.46	$53.07	$66.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.30 / $50.74 / $60.70	Professional	$42.30	$50.74	$60.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.22 / $47.43 / $124.91	Facility	$39.22	$47.43	$124.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $57.45 / $92.43	Professional	$43.67	$57.45	$92.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.92 / $67.92 / $67.92	Facility	$67.92	$67.92	$67.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.90 / $72.23 / $109.55	Professional	$51.90	$72.23	$109.55
United Facility/Professional Professional Modifier Low / Median / High Price $55.81 / $74.89 / $116.06	Professional	$55.81	$74.89	$116.06

Nationwide rates for HCPCS 99425

See more rates by state