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 $48.98 / $48.98 / $57.54	Facility	$48.98	$48.98	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $51.29 / $60.26	Professional	$43.65	$51.29	$60.26
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $53.70 / $58.88	Professional	$51.29	$53.70	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $53.70 / $114.82	Professional	$43.65	$53.70	$114.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $134.90	Professional	$38.02	$51.29	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $69.18 / $123.03	Professional	$45.71	$69.18	$123.03