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Ongoing Daily Care For A Very Low Birth Weight Newborn

Ohio 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?

$135

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $135 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $105 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 10 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$135$115 to $170
FacilityA hospital or hospital-owned outpatient department$105$105 to $162

How much rates vary

Facilitymedian $105 · 10th to 90th $105 to $204Professionalmedian $135 · 10th to 90th $105 to $282
$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $105professional $135

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. 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
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$117.49
Typical High
$281.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$144.54
Typical High
$234.42
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
CareSource
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$125.89
Typical High
$162.18
CareSource
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$154.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$162.18
Typical High
$426.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$165.96
Typical High
$288.40
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$1,202.26
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$165.96
Typical High
$288.40
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$114.82
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$141.25
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$269.15
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$154.88
Typical High
$245.47

Where Ohio 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.

Ohio $135 · 36th 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.