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Indiana rates for HCPCS 99480

Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.11 / $101.11 / $101.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.66 / $104.54 / $177.09
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.00 / $141.10 / $163.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.13 / $167.43 / $225.56
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.44 / $127.31 / $159.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.09 / $127.31 / $159.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.90 / $132.90 / $132.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.91 / $135.63 / $221.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.24 / $125.06 / $173.08