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Virginia 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 $112 · 10th–90th $76–$2290%10%10th90th$112Professionalmedian $93 · 10th–90th $76–$1910%10%20%10th90th$93$50.0$100.0$200.0$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
$75.86 / $154.88 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $87.10 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $147.91
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $91.20 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $102.33 / $162.18
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $87.10 / $144.54
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $95.50 / $162.18
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $109.65 / $177.83
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $109.65 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $112.20 / $173.78