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Utah rates for MS-DRG 790

Extreme immaturity or respiratory distress syndrome, neonate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,905.00 / $84,992.00 / $121,366.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,893.00 / $3,626.00 / $87,601.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,582.00 / $4,405.00 / $96,502.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.00 / $3,570.00 / $85,009.88