go back

Pennsylvania 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 $148 · 10th–90th $62–$3980%10%20%10th90th$148Professionalmedian $85 · 10th–90th $71–$3020%20%10th90th$85$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$61.66 / $147.91 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $87.10 / $302.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $77.62 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $89.13 / $147.91
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $102.33 / $158.49
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $83.18 / $123.03
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $154.88 / $489.78
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $104.71 / $147.91
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $81.28 / $169.82
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $123.03 / $131.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $74.13 / $83.18
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $74.13 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $85.11 / $151.36