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Montana rates for MS-DRG 790

Extreme immaturity or respiratory distress syndrome, neonate

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,970.00 / $40,750.00 / $47,500.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138,376.57 / $138,376.57 / $138,376.57
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53,842.52 / $53,842.52 / $138,376.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,200.00 / $3,200.00 / $76,849.00