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Daily Critical Care For A Critically Ill Newborn, First Day

Pennsylvania rates for HCPCS 99468

A physician or other qualified clinician provides the first day of intensive, ongoing hospital care for a critically ill newborn who is 28 days old or younger. Because the newborn's condition is unstable and needs close, continuous attention, this covers all connected care given that day rather than a single brief visit. Each following day of similarly intensive care is handled as its own separate service.

Rates data updated October 2026.

How much does Daily Critical Care For A Critically Ill Newborn, First Day cost?

$912

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $912 for this service. The price depends on where it is billed: about $912 from a physician practice, and about $1,000 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 13 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$912$871 to $1,514
FacilityA hospital or hospital-owned outpatient department$1,000$871 to $4,266

How much rates vary

Facilitymedian $1,000 · 10th to 90th $708 to $5,012Professionalmedian $912 · 10th to 90th $724 to $1,778
$1K$2K$5K$10K$20K$50Kfacility $1,000professional $912

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$707.95
Median
$707.95
Typical High
$1,862.09
Aetna
Setting
Professional
Modifier
None
Typical Low
$707.95
Median
$724.44
Typical High
$954.99
Ambetter
Setting
Professional
Modifier
None
Typical Low
$794.33
Median
$1,258.93
Typical High
$1,318.26
AmeriHealth
Setting
Professional
Modifier
None
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,230.27
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$891.25
Median
$1,445.44
Typical High
$1,819.70
Cigna
Setting
Professional
Modifier
None
Typical Low
$831.76
Median
$912.01
Typical High
$1,513.56
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$912.01
Median
$1,230.27
Typical High
$1,819.70
Geisinger
Setting
Professional
Modifier
None
Typical Low
$794.33
Median
$933.25
Typical High
$1,698.24
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$1,122.02
Median
$1,318.26
Typical High
$8,709.64
Independence Blue Cross
Setting
Professional
Modifier
None
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,230.27
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$707.95
Median
$707.95
Typical High
$1,862.09
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$707.95
Median
$724.44
Typical High
$870.96
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$870.96
Median
$891.25
Typical High
$1,949.84
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$870.96
Median
$1,000.00
Typical High
$1,000.00
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$870.96
Median
$891.25
Typical High
$1,000.00
United
Setting
Professional
Modifier
None
Typical Low
$812.83
Median
$977.24
Typical High
$1,380.38

Where Pennsylvania sits

The same service costs 2.9 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 37th of 51

$912

AK $2,188FL $759

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.