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Ongoing Daily Care For A Very Low Birth Weight Newborn

North Carolina rates for HCPCS 99478

A newborn who is not critically ill but still needs a high level of monitoring, most often because of a very low birth weight, receives ongoing daily medical management in the hospital. This covers each additional day of this intensive newborn care for the smallest, lowest-weight babies, rather than the initial day of care or care for a critically ill infant.

Rates data updated July 2026.

How much does Ongoing Daily Care For A Very Low Birth Weight Newborn cost?

$234

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $234 for this service. The price depends on where it is billed: about $234 from a physician practice, and about $158 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$234$170 to $282
FacilityA hospital or hospital-owned outpatient department$158$132 to $214

How much rates vary

Facilitymedian $158 · 10th to 90th $115 to $331Professionalmedian $234 · 10th to 90th $123 to $339
$100.0$500.0$2.0K$10.0Kfacility $158professional $234

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$338.84
Typical High
$389.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$131.83
Typical High
$338.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$125.89
Typical High
$169.82
BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$275.42
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$35,481.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$186.21
Typical High
$338.84
Medcost
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$245.47
Medcost
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$154.88
Typical High
$263.03
Medcost
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$794.33
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$204.17
Typical High
$263.03
United
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$151.36
Typical High
$269.15
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$1,348.96

Where North Carolina sits

The same service costs 2.5 times more in Minnesota than in Alabama. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

North Carolina $234 · 3rd of 51
MN $275AL $112

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.