Price Checker / CPT 99157
How much does Mod Sed Other Phys/qhp Ea cost?
CPT 99157 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is in line with what this normally costs. No need to dispute.
Fair price
$170–$200
What this should cost
With insurance
~$560
Typical out-of-pocket
Overcharged if over
$250
Push back above this
What hospitals charge for Mod Sed Other Phys/qhp Ea
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Wyoming County Community Health System Warsaw, NY | $159 | — | 4519% |
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 Other Phys/qhp Ea
CPT code 99157 refers to mod sed other phys/qhp ea (billing description: "Mod sed other phys/qhp ea"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $54 in a facility (hospital or surgery center) and $54 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.