go back

Louisiana 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.

Facilitymedian $52 · 10th–90th $0–$870%20%10th90th$52Professionalmedian $51 · 10th–90th $40–$650%20%10th90th$51$0.0$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $60.26 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $64.57
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.03
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $66.07 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $60.26 / $91.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $154.88 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $64.57 / $93.33