Moderate sedation by non-anesthesia physician, first 15 minutes, child under 5

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Mod Cs Diff Phys<5Yrs 1St 15

Payers reporting CPT 99155

Payer pricing summary

Low

Average

$269

Median

$245

High

$1.3k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +26 other terms	139	$85	$415	$1.1k	255%	1–10	$29 – $8.3k
2	Florida Blue percent of total billed charges · bothfrom % of charges · +1 other terms	1	$561	$561	$93	17%	1–10	$457 – $697
3	UnitedHealthcare fee schedule · outpatient · +32 other terms	204	$87	$189	$192	102%	—	$1 – $1.7k
4	Blue Cross Blue Shield fee schedule · outpatient · +29 other terms	203	$267	$272	$136	50%	—	$0 – $677
5	Aetna fee schedule · outpatient · +30 other terms	127	$80	$354	$1.1k	312%	—	$20 – $10.6k
6	Anthem fee schedule · outpatient · +24 other terms	93	$90	$218	$269	123%	—	$47 – $1.6k
7	MultiPlan fee schedule · outpatient · +18 other terms	87	$314	$362	$202	56%	—	$60 – $924
8	Cigna fee schedule · outpatient · +25 other terms	79	$132	$206	$196	96%	—	$74 – $1.1k
9	Molina fee schedule · outpatient · +24 other terms	55	$78	$95	$107	113%	—	$16 – $541
10	Kaiser fee schedule · outpatient · +19 other terms	47	$79	$127	$104	82%	—	$74 – $678
11	WellCare fee schedule · both · +16 other terms	39	$79	$70	$24	35%	—	$14 – $97
12	Medica fee schedule · outpatient · +17 other terms	33	$128	$215	$97	45%	—	$33 – $419
13	Caresource fee schedule · outpatient · +15 other terms	32	$158	$240	$58	24%	—	$57 – $296
14	Regence professional · fee schedule · outpatient · +14 other terms	28	$81	$133	$63	48%	—	$74 – $256
15	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	26	$138	$134	$30	22%	—	$50 – $186
16	First Health fee schedule · outpatient · +18 other terms	25	$463	$456	$338	74%	—	$78 – $2.0k
17	Optum professional · fee schedule · outpatient · +15 other terms	25	$76	$75	$6	8%	—	$57 – $84
18	Aetna Better Health fee schedule · outpatient · +16 other terms	24	$78	$89	$50	56%	—	$29 – $253
19	Phcs fee schedule · outpatient · +12 other terms	23	$227	$210	$93	45%	—	$80 – $356
20	Highmark facility · fee schedule · outpatient · +10 other terms	22	$89	$80	$18	22%	—	$64 – $131
21	Devoted fee schedule · outpatient · +12 other terms	21	$79	$79	$1	1%	—	$78 – $80
22	Amerihealth Caritas facility · fee schedule · outpatient · +11 other terms	20	$89	$90	$28	30%	—	$17 – $195
23	Bcbs Tx fee schedule · outpatient · +5 other terms	18	$333	$334	$104	31%	—	$99 – $510
24	Medicare fee schedule · outpatient · +11 other terms	18	$78	$77	$1	2%	—	$74 – $79
25	Wellmark fee schedule · both · +15 other terms	17	$117	$120	$26	21%	—	$76 – $151

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