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New Jersey 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 $60 · 10th–90th $5–$660%20%40%10th90th$60Professionalmedian $41 · 10th–90th $4–$740%10%10th90th$41$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
$5.01 / $60.26 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $7.08 / $67.61
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.13 / $5.13 / $5.13
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $5.75 / $14.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $8.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $95.50 / $138.04
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $57.54 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $44.67 / $100.00