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North Carolina rates for HCPCS 99475

Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$813.17 / $1,619.44 / $1,619.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $635.70 / $35,600.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$476.16 / $614.23 / $870.17
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,045.84 / $2,710.30 / $2,710.30