Tynbil: Know the *real* price for healthcare services

North Dakota 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 $51.03 / $51.03 / $58.64	Facility	$51.03	$51.03	$58.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.86 / $52.63 / $61.89	Professional	$45.86	$52.63	$61.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $109.95 / $137.76	Professional	$86.29	$109.95	$137.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.82 / $128.86 / $179.67	Professional	$90.82	$128.86	$179.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $43.38 / $58.25 / $86.90	Facility	$43.38	$58.25	$86.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $122.30 / $369.98	Professional	$67.27	$122.30	$369.98
United Facility/Professional Professional Modifier Low / Median / High Price $62.80 / $112.05 / $152.66	Professional	$62.80	$112.05	$152.66