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Sedation By a Separate Provider, Young Child

Wisconsin rates for HCPCS 99155

This service covers moderate sedation given to a child younger than 5 by a doctor or other qualified provider who is not the one performing the main procedure. The sedating provider monitors the child's breathing, heart rate, and level of consciousness throughout, allowing the other provider to focus on the procedure itself. It covers the first stretch of sedation time, typically the initial 15 minutes.

Facilitymedian $245 · 10th–90th $87$5370%10%10th90th$245Professionalmedian $102 · 10th–90th $76$3550%10%20%10th90th$102$50.0$100.0$200.0$500.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$269.15
Typical High
$537.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$87.10
Typical High
$371.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$114.82
Typical High
$281.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$245.47
Typical High
$389.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$190.55
Typical High
$234.42
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$102.33
Typical High
$162.18
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$165.96
Typical High
$239.88
Medica
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$97.72
Typical High
$173.78
Medica
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$147.91
Typical High
$512.86
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Network Health
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$204.17
Typical High
$234.42
Quartz
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$190.55
Typical High
$275.42
Quartz
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$512.86
Typical High
$512.86
Quartz
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$190.55
Typical High
$512.86
Security Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Security Health
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$309.03
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$138.04
Typical High
$269.15