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New York rates for HCPCS 99157

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; each additional 15 minutes intraservice time (List separately in addition to code for primary service)

Facilitymedian $148 · 10th–90th $50$8510%10%10th90th$148Professionalmedian $71 · 10th–90th $47$2750%20%10th90th$71$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
$57.54 / $165.96 / $851.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $79.43 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $51.29 / $83.18
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $75.86 / $194.98
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $63.10 / $147.91
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $79.43 / $120.23
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $72.44 / $125.89
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $389.05
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $275.42
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $89.13 / $154.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $181.97 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $109.65 / $147.91
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $64.57 / $75.86
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $64.57 / $114.82