Tynbil: Know the *real* price for healthcare services

Washington, DC rates for HCPCS 99426

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; first 30 minutes of clinical staff time directed by physician or other qualified health care professional, per calendar month.

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.55 / $47.55 / $60.51	Facility	$47.55	$47.55	$60.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $51.28 / $61.66	Professional	$46.18	$51.28	$61.66
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $48.82 / $51.39 / $65.84	Professional	$48.82	$51.39	$65.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.92 / $56.75 / $139.30	Professional	$41.92	$56.75	$139.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.82 / $52.27 / $140.74	Professional	$41.82	$52.27	$140.74
United Facility/Professional Professional Modifier Low / Median / High Price $58.59 / $131.16 / $149.18	Professional	$58.59	$131.16	$149.18