Tynbil: Know the *real* price for healthcare services

Maryland 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 $41.03 / $41.03 / $56.19	Facility	$41.03	$41.03	$56.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.66 / $37.32 / $47.85	Professional	$28.66	$37.32	$47.85
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $36.22 / $50.66	Professional	$36.22	$36.22	$50.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.58 / $49.38 / $83.50	Professional	$30.58	$49.38	$83.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $43.36 / $70.97	Professional	$29.19	$43.36	$70.97
United Facility/Professional Professional Modifier Low / Median / High Price $37.29 / $57.71 / $93.42	Professional	$37.29	$57.71	$93.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.07 / $61.36 / $76.68	Professional	$43.07	$61.36	$76.68