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Pennsylvania rates for HCPCS 99153

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; each additional 15 minutes intraservice time (List separately in addition to code for primary service)

Facilitymedian $135 · 10th–90th $26–$8510%5%10%10th90th$135Professionalmedian $19 · 10th–90th $10–$850%20%10th90th$19$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$26.30 / $125.89 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $21.38 / $87.10
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $12.59 / $21.38
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,995.26 / $4,073.80
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $14.45
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $11.75 / $19.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $12.59 / $21.38
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $18.62 / $29.51
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $12.02 / $19.95
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $69.18 / $645.65
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,995.26 / $3,467.37
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $14.45
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $16.98 / $190.55
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $12.30 / $25.70
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,630.27 / $5,495.41
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $22.39 / $23.99
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $11.48 / $11.48
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $10.72 / $21.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $12.02 / $23.44