Covers further time a doctor or other qualified professional spends during a month managing a single serious, complex ongoing health problem: reviewing results, adjusting treatment, and coordinating with everyone else involved in that person's care. It is billed in addition to the main monthly management service.
Rates data updated October 2026.
How much does Extra Monthly Time Managing One Complex Condition cost?
$63.10
Typical physician fee. In New Hampshire, October 2026.
Insurers have agreed to pay about $63.10 for this service. Most negotiated rates run $48.98 to $67.61.
These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.
How much rates vary
Professionalmedian $63 · 10th to 90th $45 to $98
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Professional
Modifier
None
Typical Low
$52.48
Median
$56.23
Typical High
$64.57
Professional
None
$52.48
$56.23
$64.57
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$26.92
Median
$28.18
Typical High
$32.36
Professional
52 · Reduced service
$26.92
$28.18
$32.36
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$63.10
Typical High
$77.62
Professional
None
$44.67
$63.10
$77.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$75.86
Typical High
$138.04
Professional
None
$60.26
$75.86
$138.04
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$67.61
Typical High
$109.65
Professional
None
$48.98
$67.61
$109.65
United
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$89.13
Typical High
$147.91
Professional
None
$61.66
$89.13
$147.91
1 more rate with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Well Sense
Setting
Facility
Modifier
HN · Bachelor's level
Typical Low
$37.15
Median
$37.15
Typical High
$37.15
Facility
HN · Bachelor's level
$37.15
$37.15
$37.15
Where New Hampshire sits
The same service costs 5.0 times more in Alaska than in Indiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.