Price Checker / CPT 99151
How much does Mod Sed Same Phys/qhp <5 Yrs cost?
CPT 99151 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is roughly 7.6x the fair price. This is well above fair — push back or dispute it.
Fair price
$270–$320
What this should cost
With insurance
~$580
Typical out-of-pocket
Overcharged if over
$400
Push back above this
The average hospital charge of $2,293 is $1,993 over the fair price (about 7.6x the fair rate).
What hospitals charge for Mod Sed Same Phys/qhp <5 Yrs
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Baptist Health Princeton Hospital , AL | $6,114 | $4,586 | 9741% |
| Hoke Hospital , NC | $416 | — | 2218% |
| Iroquois Memorial Hospital WATSEKA, IL | $350 | $245 | 463% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Mod Sed Same Phys/qhp <5 Yrs
CPT code 99151 refers to mod sed same phys/qhp <5 yrs (billing description: "Mod sed same phys/qhp <5 yrs"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $21 in a facility (hospital or surgery center) and $62 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.