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Massachusetts rates for HCPCS 99157

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

Facilitymedian $151 · 10th–90th $45–$7760%20%10th90th$151Professionalmedian $105 · 10th–90th $55–$9120%10%10th90th$105$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$44.67 / $70.79 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $151.36 / $1,380.38
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $147.91 / $389.05
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $89.13 / $389.05
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $169.82 / $218.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $107.15 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $77.62 / $165.96
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $60.26 / $114.82
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $54.95 / $97.72
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $85.11 / $141.25
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $331.13 / $1,202.26
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $446.68
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $147.91 / $389.05
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $89.13 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $93.33 / $162.18