Tynbil: Know the *real* price for healthcare services

Montana 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 $39.93 / $49.88 / $66.58	Professional	$39.93	$49.88	$66.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.95 / $61.52 / $94.64	Professional	$51.95	$61.52	$94.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.92 / $79.92 / $112.50	Facility	$79.92	$79.92	$112.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.87 / $80.44 / $142.31	Professional	$62.87	$80.44	$142.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.75 / $58.83 / $94.64	Facility	$41.75	$58.83	$94.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.28 / $73.77 / $108.15	Professional	$53.28	$73.77	$108.15
United Facility/Professional Professional Modifier Low / Median / High Price $92.22 / $100.93 / $142.69	Professional	$92.22	$100.93	$142.69