Tynbil: Know the *real* price for healthcare services

Nationwide rates for HCPCS 99426

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; first 30 minutes of clinical staff time directed by physician or other qualified health care professional, per calendar month.

Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $63.10 / $114.82	Facility		$44.67	$63.10	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $70.79	Professional		$39.81	$51.29	$70.79
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $58.88 / $58.88 / $58.88	Professional	25	$58.88	$58.88	$58.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $50.12 / $158.49	Facility		$38.90	$50.12	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $57.54 / $97.72	Professional		$38.90	$57.54	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $199.53 / $549.54	Facility		$75.86	$199.53	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $77.62 / $151.36	Professional		$50.12	$77.62	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $114.82 / $354.81	Facility		$52.48	$114.82	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $67.61 / $114.82	Professional		$46.77	$67.61	$114.82

Nationwide rates for HCPCS 99426

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