Tynbil: Know the *real* price for healthcare services

West Virginia 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 $49.46 / $49.46 / $55.79	Facility	$49.46	$49.46	$55.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.97 / $49.46 / $57.26	Professional	$39.97	$49.46	$57.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.69 / $46.24 / $86.31	Facility	$40.69	$46.24	$86.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $57.31 / $57.31	Professional	$57.31	$57.31	$57.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.92 / $67.92 / $67.92	Facility	$67.92	$67.92	$67.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.66 / $59.76 / $237.00	Professional	$48.66	$59.76	$237.00
United Facility/Professional Professional Modifier Low / Median / High Price $48.08 / $76.56 / $102.08	Professional	$48.08	$76.56	$102.08