go back

New Hampshire rates for HCPCS 99478

Subsequent Intensive Care Infant < 1500 Grams

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.42 / $427.42 / $427.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.69 / $136.02 / $340.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.80 / $159.90 / $251.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.52 / $227.36 / $345.63
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.16 / $228.37 / $448.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.33 / $203.73 / $304.83
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.89 / $125.87 / $185.03