go back

Pennsylvania 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 $65 · 10th–90th $5–$1700%20%10th90th$65Professionalmedian $8 · 10th–90th $4–$720%20%10th90th$8$1.0$10.0$100.0$1.0K$10.0K

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
$4.90 / $64.57 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $6.76 / $69.18
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $8.32
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $5.62 / $6.46
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
$53.70 / $56.23 / $100.00
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
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $97.72 / $138.04
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $66.07 / $107.15
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $144.54 / $331.13
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $5.62 / $6.46
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.90 / $48.98 / $74.13
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $18.62 / $85.11
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,818.38 / $3,890.45
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $120.23 / $154.88
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $52.48 / $61.66
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $7.76 / $53.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $44.67 / $83.18