Tynbil: Know the *real* price for healthcare services

Idaho 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 Professional Modifier Low / Median / High Price $44.64 / $57.30 / $72.13	Professional	$44.64	$57.30	$72.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.64 / $78.75 / $112.50	Professional	$64.64	$78.75	$112.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $46.75 / $66.58 / $89.60	Facility	$46.75	$66.58	$89.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $81.13 / $97.14 / $117.74	Professional	$81.13	$97.14	$117.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.56 / $97.23 / $115.38	Professional	$55.56	$97.23	$115.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $69.62 / $84.65 / $100.75	Professional	$69.62	$84.65	$100.75
United Facility/Professional Professional Modifier Low / Median / High Price $64.38 / $80.05 / $109.63	Professional	$64.38	$80.05	$109.63