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 $47.64 / $52.98 / $69.58	Facility		$47.64	$52.98	$69.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.35 / $66.31	Professional		$40.74	$51.35	$66.31
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $59.03 / $59.03 / $59.03	Professional	25	$59.03	$59.03	$59.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.53 / $45.38 / $119.50	Facility		$37.53	$45.38	$119.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.66 / $57.89 / $94.28	Professional		$43.66	$57.89	$94.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $65.88 / $65.88	Facility		$65.88	$65.88	$65.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.23 / $73.05 / $114.27	Professional		$50.23	$73.05	$114.27
United Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $79.48 / $123.43	Professional		$58.80	$79.48	$123.43

Nationwide rates for HCPCS 99426

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