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Ongoing Daily Care For A Very Low Birth Weight Newborn

Pennsylvania 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 Pennsylvania, 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 $107 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 12 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$112 to $186
FacilityA hospital or hospital-owned outpatient department$107$107 to $107

How much rates vary

Facilitymedian $107 · 10th to 90th $107 to $162Professionalmedian $135 · 10th to 90th $105 to $324
$100$200$500facility $107professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$125.89
Typical High
$338.84
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$144.54
Typical High
$229.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$165.96
Typical High
$263.03
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$190.55
Typical High
$389.05
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$147.91
Typical High
$251.19
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$190.55
Typical High
$295.12
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$134.90
Typical High
$331.13
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$204.17
Typical High
$269.15
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$131.83
Typical High
$177.83
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$158.49
Typical High
$269.15

Where Pennsylvania sits

The same service costs 2.5 times more in Minnesota than in Alabama. 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· 26th of 51

$135

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.