Tynbil: Know the *real* price for healthcare services

North Dakota 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 Facility Modifier Low / Median / High Price $47.86 / $47.86 / $61.66	Facility	$47.86	$47.86	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $69.18	Professional	$39.81	$51.29	$69.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $112.20 / $147.91	Professional	$85.11	$112.20	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $190.55	Professional	$95.50	$125.89	$190.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $53.70 / $91.20	Facility	$41.69	$53.70	$91.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $120.23 / $389.05	Professional	$70.79	$120.23	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $97.72 / $138.04	Professional	$61.66	$97.72	$138.04