Tynbil: Know the *real* price for healthcare services

Maine 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	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $75.86	Professional	$41.69	$52.48	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $69.18 / $104.71	Professional	$43.65	$69.18	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $70.79 / $112.20	Professional	$40.74	$70.79	$112.20
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $69.18 / $125.89	Professional	$44.67	$69.18	$125.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $56.23 / $93.33	Professional	$42.66	$56.23	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $81.28 / $107.15	Professional	$53.70	$81.28	$107.15