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Pennsylvania 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 $107 · 10th–90th $48–$2,4550%10%20%10th90th$107Professionalmedian $72 · 10th–90th $54–$4470%20%10th90th$72$10.0$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
$47.86 / $107.15 / $2,454.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $75.86 / $446.68
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
$57.54 / $60.26 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $67.61 / $114.82
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $77.62 / $120.23
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $63.10 / $93.33
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $138.04 / $489.78
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $81.28 / $120.23
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $64.57 / $141.25
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $93.33 / $102.33
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $63.10
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $60.26 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $67.61 / $123.03