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Initial Hospital Or Observation Visit, Lower Complexity

Colorado rates for HCPCS 99221

The first evaluation by a doctor or other qualified clinician after a person is admitted to hospital as an inpatient or placed under observation care, at the level used for more straightforward cases. It covers taking the history, examining the patient, reviewing results and setting out the initial plan of care for that day.

Rates data updated July 2026.

Facilitymedian $83 · 10th–90th $60$1860%10%10th90th$83Professionalmedian $98 · 10th–90th $60$2450%10%10th90th$98$1.0$5.0$20.0$100.0$500.0

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
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$66.07
Typical High
$81.28
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$87.10
Typical High
$245.47
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$109.65
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$128.82
Typical High
$194.98
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$123.03
Typical High
$186.21
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$107.15
Typical High
$323.59
Select Health
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$138.04
Typical High
$158.49
Select Health
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$83.18
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$112.20
Typical High
$741.31
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$125.89
Typical High
$234.42