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Colorado rates for HCPCS 99254

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $13 · 10th–90th $10–$1320%20%10th90th$13Professionalmedian $166 · 10th–90th $95–$4370%10%10th90th$166$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$10.00 / $12.88 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $162.18 / $436.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $181.97 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $218.78 / $323.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $199.53 / $426.58
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $141.25 / $141.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $213.80 / $380.19