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Wisconsin 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 $355 · 10th–90th $66–$9770%10%10th90th$355Professionalmedian $81 · 10th–90th $56–$3890%10%10th90th$81$50.0$100.0$200.0$500.0$1.0K$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
$75.86 / $426.58 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $72.44 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $79.43 / $204.17
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $63.10 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $177.83 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $138.04 / $169.82
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $74.13 / $117.49
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $114.82 / $165.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $72.44 / $128.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $100.00 / $389.05
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $144.54 / $165.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $128.82 / $177.83
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $389.05 / $389.05
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $144.54 / $389.05
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $229.09 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $93.33 / $199.53