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Wisconsin 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 $324 · 10th–90th $33–$6920%5%10%10th90th$324Professionalmedian $16 · 10th–90th $9–$590%10%10th90th$16$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
$154.88 / $338.84 / $707.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $14.13 / $70.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $13.18 / $35.48
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $18.62 / $18.62
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $12.30 / $22.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $37.15 / $58.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $25.70 / $33.11
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $12.88 / $22.91
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $23.99 / $34.67
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.72 / $21.38 / $154.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $17.38 / $89.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $24.55 / $29.51
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $29.51 / $40.74
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $89.13 / $89.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $25.12 / $89.13
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $16.22
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $43.65 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $20.89 / $60.26