Tynbil: Know the *real* price for healthcare services

Washington, DC rates for HCPCS 99425

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 provided personally 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 $49.35 / $49.35 / $57.26	Facility	$49.35	$49.35	$57.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.02 / $52.39 / $60.82	Professional	$47.02	$52.39	$60.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $51.04 / $53.73 / $62.32	Professional	$51.04	$53.73	$62.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.46 / $59.20 / $131.83	Professional	$43.46	$59.20	$131.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.74 / $52.61 / $135.93	Professional	$42.74	$52.61	$135.93
United Facility/Professional Professional Modifier Low / Median / High Price $55.41 / $124.25 / $143.49	Professional	$55.41	$124.25	$143.49