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 | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.30 | $140.30 | $157.15 | |
Aetna
| Professional | $44.00 | $57.26 | $102.43 | |
Cigna
| Professional | $55.51 | $157.58 | $206.68 | |
Moda Health
| Facility | $44.64 | $62.58 | $143.40 | |
Moda Health
| Professional | $91.88 | $159.80 | $197.25 | |
Premera BCBS
| Professional | $76.00 | $121.80 | $182.00 | |
Providence
| Facility | $46.86 | $66.58 | $143.40 | |
Providence
| Professional | $68.84 | $127.28 | $212.80 | |
United
| Professional | $147.79 | $165.34 | $208.09 |