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 | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.15 | $47.30 | $101.84 | |
Aetna
| Professional | $39.43 | $49.17 | $61.66 | |
Ambetter
| Professional | $49.33 | $49.33 | $58.04 | |
BCBS
| Professional | $35.68 | $52.71 | $93.15 | |
Cigna
| Professional | $47.20 | $74.58 | $113.67 | |
Lucent Health
| Facility | $222.53 | $241.68 | $241.68 | |
Lucent Health
| Professional | $309.19 | $389.46 | $389.46 | |
United
| Professional | $58.36 | $66.04 | $121.23 |