Price Checker / CPT 99152

How much does Moderate sedation (first 15 min) cost?

CPT 99152 · Based on 2026 Medicare rates and hospital-published pricing

Severe overcharge

The average hospital charge is around 48x the fair price — among the most extreme markups. Dispute this.

Fair price

$75–$150

What this should cost

With insurance

~$690

Typical out-of-pocket

Overcharged if over

$190

Push back above this

The average hospital charge of $5,228 is $5,118 over the fair price (about 48x the fair rate).

What hospitals charge for Moderate sedation (first 15 min)

From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.

HospitalGross ChargeCash Ratevs Medicare
Centrastate Medical Center

FREEHOLD, NJ

$13,933$4,03726986%
McLaren Flint

FLINT, MI

$8,233$4,11615905%
BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR

Taylor, TX

13520%
Baptist Health Princeton Hospital

, AL

$6,114$4,58611786%
Bear Lake Memorial Hospital

MONTPELIER, ID

$767$6521391%
Iroquois Memorial Hospital

WATSEKA, IL

$365$256610%
BARAGA COUNTY MEMORIAL HOSPITAL

L' ANSE, MI

$175$175240%

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About Moderate sedation (first 15 min)

CPT code 99152 refers to moderate sedation (first 15 min) (billing description: "Mod sed same phys/qhp 5/>yrs"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $11 in a facility (hospital or surgery center) and $51 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

  1. 1Send us your billwe'll identify this code and compare it against the rates shown above.
  2. 2Get a dispute letterciting the Medicare rate and your hospital's own published pricing data.
  3. 3We negotiate for you25% of savings, no savings = no fee.

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