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Maine 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.06 / $211.06 / $211.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.11 / $87.71 / $123.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.98 / $97.10 / $155.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.57 / $116.58 / $180.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.40 / $117.32 / $179.97
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.06 / $211.06 / $211.06
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.79 / $88.00 / $150.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.09 / $130.99 / $185.05