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Illinois rates for HCPCS G0500

Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)

Facilitymedian $234 · 10th–90th $8–$8510%10%10th90th$234Professionalmedian $10 · 10th–90th $5–$760%10%10th90th$10$1.0$5.0$20.0$100.0$500.0

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
$7.76 / $234.42 / $851.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $9.12 / $72.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $5.75 / $61.66
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $50.12 / $95.50
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $52.48 / $67.61
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $87.10 / $354.81
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $7.41 / $74.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $40.74 / $95.50