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North Dakota 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)

Facilitymedian $42 · 10th–90th $34–$490%20%10th90th$42Professionalmedian $47 · 10th–90th $32–$1000%10%10th90th$47$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $46.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $38.02 / $53.70
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $89.13 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $102.33 / $154.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $41.69 / $70.79
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $93.33 / $302.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $69.18 / $109.65