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
| Professional | $43.66 | $50.74 | $58.07 | |
Anthem BCBS
| Professional | $51.49 | $65.48 | $96.65 | |
Cigna
| Professional | $46.55 | $68.06 | $104.43 | |
Harvard Pilgrim
| Professional | $53.25 | $65.09 | $98.12 | |
Martin's Point
| Professional | $44.14 | $51.00 | $58.62 | |
United
| Professional | $61.44 | $86.04 | $121.20 |