Tynbil: Know the *real* price for healthcare services

Georgia 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 $41.06 / $43.36 / $47.02	Facility	$41.06	$43.36	$47.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.06 / $48.75 / $60.46	Professional	$41.06	$48.75	$60.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.51 / $56.79 / $95.92	Professional	$47.51	$56.79	$95.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.81 / $71.70 / $115.25	Professional	$49.81	$71.70	$115.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.37 / $62.00 / $130.12	Professional	$49.37	$62.00	$130.12
United Facility/Professional Professional Modifier Low / Median / High Price $53.38 / $75.29 / $119.04	Professional	$53.38	$75.29	$119.04