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Colorado rates for HCPCS 99221

Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.

Facilitymedian $68 · 10th–90th $54–$1860%10%20%10th90th$68Professionalmedian $98 · 10th–90th $62–$2140%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $67.61 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $97.72 / $213.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $128.82 / $194.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $107.15 / $323.59
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $83.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $134.90 / $229.09