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New York 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 $158 · 10th–90th $79$3890%10%20%10th90th$158Professionalmedian $93 · 10th–90th $74$2570%20%10th90th$93$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
$89.13 / $194.98 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $97.72 / $338.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $83.18 / $125.89
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $109.65 / $275.42
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $95.50 / $239.88
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $117.49 / $177.83
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $102.33 / $173.78
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $263.03 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $158.49 / $218.78
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $91.20 / $123.03
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $91.20 / $162.18