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Ohio rates for HCPCS 99151

Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intraservice time, patient younger than 5 years of age

Facilitymedian $93 · 10th–90th $26–$5750%10%10th90th$93Professionalmedian $45 · 10th–90th $23–$1200%10%20%10th90th$45$0.2$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
$25.70 / $93.33 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $56.23 / $158.49
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $28.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $25.70 / $48.98
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $22.91 / $26.92
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $63.10 / $117.49
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $38.90
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $64.57 / $117.49
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $32.36 / $33.11
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $48.98 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $54.95 / $112.20