Coverage lookup — colonoscopy · Aetna

This example calls the /v1/coverage/summary endpoint — the same lookup a developer would run to check, in real time, whether a specific procedure is covered before a patient schedules care. Given a CPT code and a payer, the API returns the carrier's coverage status, any prior-authorization requirement, and standard cost-sharing terms (deductible applicability, coinsurance, copay) in a single response — replacing the manual step of calling the insurer or digging through a policy PDF. The request below uses colonoscopy (CPT 45378) under Aetna as a representative case; every endpoint works the same way for other supported procedures and carriers — see the full endpoint reference for the current list.

GET /v1/coverage/summary
    ?cpt_code=45378
    &carrier=aetna

Authorization: Bearer ck_live_…

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