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Utah 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
$109.65 / $109.65 / $109.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $107.15 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $123.03 / $134.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $190.55
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $107.15 / $138.04
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $169.82 / $251.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $117.49 / $165.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $120.23 / $177.83