Tynbil: Know the *real* price for healthcare services

Maine 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 $42.66 / $51.29 / $64.57	Professional	$42.66	$51.29	$64.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $67.61 / $100.00	Professional	$43.65	$67.61	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $67.61 / $107.15	Professional	$40.74	$67.61	$107.15
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $64.57 / $114.82	Professional	$44.67	$64.57	$114.82
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $95.50	Professional	$43.65	$52.48	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $109.65	Professional	$53.70	$75.86	$109.65