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Moderate Sedation For A Procedure (Young Child)

Pennsylvania rates for HCPCS 99151

The administration and monitoring of moderate sedation, medication that makes a patient drowsy and comfortable but not fully unconscious, given by the same doctor performing another procedure on a child younger than five. It covers the initial period of sedation, with the doctor overseeing both the sedation and the separate procedure at the same time.

Facilitymedian $100 · 10th–90th $32$4170%10%20%10th90th$100Professionalmedian $59 · 10th–90th $23$1200%10%20%10th90th$59$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$100.00
Typical High
$416.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$58.88
Typical High
$120.23
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$60.26
Typical High
$131.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$56.23
Typical High
$117.49
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$91.20
Typical High
$141.25
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$79.43
Typical High
$102.33
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$489.78
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$47.86
Typical High
$89.13
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$57.54
Typical High
$117.49
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$109.65
Typical High
$123.03
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$81.28
Typical High
$309.03
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$29.51
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$56.23
Typical High
$114.82