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New Hampshire rates for MS-DRG 790

Extreme immaturity or respiratory distress syndrome, neonate

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,692.00 / $61,386.00 / $126,431.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,122.00 / $5,282.00 / $122,659.10
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,269.43 / $85,925.18 / $126,234.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$970.93 / $6,199.00 / $121,782.32