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Ohio 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 $115 · 10th–90th $58–$1,3180%10%10th90th$115Professionalmedian $79 · 10th–90th $56–$9770%20%10th90th$79$1.0$5.0$20.0$100.0$500.0$2.0K

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 / $190.55 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $109.65 / $1,288.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $60.26 / $109.65
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $61.66 / $89.13
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $60.26 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $74.13 / $117.49
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $194.98 / $263.03
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $75.86 / $123.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $41.69
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $66.07 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $67.61 / $123.03