go back

Maine 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 $132 · 10th–90th $132–$1820%20%40%90th$132Professionalmedian $65 · 10th–90th $56–$1700%20%10th90th$65$50.0$100.0$200.0$500.0

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
$131.83 / $131.83 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $61.66 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $69.18 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $74.13 / $128.82
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $77.62 / $134.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $64.57 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $85.11 / $131.83