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Nationwide rates for HCPCS 99155

Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger than 5 years of age

Facilitymedian $178 · 10th–90th $83$4790%20%10th90th$178Professionalmedian $100 · 10th–90th $76$2690%20%40%10th90th$100$0.0$0.2$2.0$20.0$200.0$2.0K$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
$81.28 / $162.18 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $95.50 / $338.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $512.86
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $93.33 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $234.42 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $117.49 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $117.49 / $194.98