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Alaska rates for MS-DRG 790

Extreme immaturity or respiratory distress syndrome, neonate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,575.00 / $105,646.00 / $227,475.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239,142.67 / $239,142.67 / $254,084.63
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,500.00 / $92,421.43 / $145,842.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,500.00 / $92,444.75 / $254,084.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,200.00 / $3,200.00 / $76,849.00