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 $42.34 / $52.47 / $67.93	Professional	$42.34	$52.47	$67.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.59 / $68.86 / $97.03	Professional	$53.59	$68.86	$97.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.73 / $71.06 / $109.91	Professional	$48.73	$71.06	$109.91
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $51.50 / $68.31 / $102.97	Professional	$51.50	$68.31	$102.97
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $43.07 / $54.54 / $75.42	Professional	$43.07	$54.54	$75.42
United Facility/Professional Professional Modifier Low / Median / High Price $62.63 / $90.32 / $122.50	Professional	$62.63	$90.32	$122.50