Tynbil: Know the *real* price for healthcare services

Rhode Island 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 $39.81 / $51.29 / $70.79	Professional	$39.81	$51.29	$70.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $104.71 / $165.96	Facility	$56.23	$104.71	$165.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $54.95 / $72.44	Professional	$40.74	$54.95	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $79.43 / $134.90	Professional	$48.98	$79.43	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	$213.80	$213.80	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $72.44 / $100.00	Professional	$53.70	$72.44	$100.00