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Massachusetts rates for HCPCS 99153

Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the 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; each additional 15 minutes intraservice time (List separately in addition to code for primary service)

Facilitymedian $79 · 10th–90th $20–$7410%5%10%10th90th$79Professionalmedian $23 · 10th–90th $10–$980%10%10th90th$23$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$21.38 / $97.72 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $27.54 / $114.82
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $28.18 / $89.13
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $17.78 / $89.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $30.20 / $39.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $22.39 / $33.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $16.22 / $33.88
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $14.45 / $28.84
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $13.18 / $23.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $18.62 / $33.11
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $70.79 / $1,202.26
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $28.18 / $89.13
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $17.78 / $89.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.72 / $10.72 / $10.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $18.62 / $36.31