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Washington 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
$102.33 / $177.83 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $100.00 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $141.25 / $229.09
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $141.25 / $204.17
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $134.90 / $204.17
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $51.29
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $158.49 / $177.83
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $109.65 / $112.20
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $158.49 / $239.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $123.03 / $199.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $138.04 / $229.09
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $85.11 / $154.88