Tynbil: Know the *real* price for healthcare services

Georgia rates for HCPCS 99427

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; each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.84 / $29.50 / $37.86	Facility	$27.84	$29.50	$37.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $38.20 / $58.85	Professional	$28.16	$38.20	$58.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.85 / $93.85 / $93.85	Professional	$93.85	$93.85	$93.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.54 / $44.77 / $68.45	Professional	$32.54	$44.77	$68.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $53.19 / $89.14	Professional	$34.82	$53.19	$89.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.42 / $50.55 / $111.39	Professional	$34.42	$50.55	$111.39
United Facility/Professional Professional Modifier Low / Median / High Price $42.90 / $60.90 / $99.93	Professional	$42.90	$60.90	$99.93