Tynbil: Know the *real* price for healthcare services

New Jersey 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 $45.77 / $53.07 / $53.86	Facility	$45.77	$53.07	$53.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.97 / $47.02 / $58.62	Professional	$39.97	$47.02	$58.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $72.23 / $111.32	Professional	$38.90	$72.23	$111.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $89.37 / $89.37 / $89.37	Professional	$89.37	$89.37	$89.37
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.39 / $66.34 / $97.48	Professional	$56.39	$66.34	$97.48
United Facility/Professional Professional Modifier Low / Median / High Price $47.90 / $72.23 / $110.54	Professional	$47.90	$72.23	$110.54