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New York rates for HCPCS 99156

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 age 5 years or older

Facilitymedian $178 · 10th–90th $66$3720%10%20%10th90th$178Professionalmedian $87 · 10th–90th $62$2750%20%10th90th$87$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
$75.86 / $204.17 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $93.33 / $309.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $67.61 / $107.15
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $95.50 / $245.47
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $83.18 / $199.53
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $104.71 / $158.49
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $93.33 / $158.49
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $436.52 / $457.09
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $109.65 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $234.42 / $338.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $138.04 / $190.55
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $81.28 / $100.00
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $81.28 / $144.54