go back

Wisconsin rates for MS-DRG 790

Extreme immaturity or respiratory distress syndrome, neonate

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,230.00 / $3,230.00 / $105,931.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.00 / $3,754.00 / $6,211.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,644.49 / $28,184.79 / $153,116.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,000.00 / $86,495.76 / $147,232.38
Network Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,582.00 / $1,942.07 / $2,228.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$952.95 / $59,953.31 / $85,930.66
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,589.96 / $3,284.29 / $99,442.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,871.00 / $94,412.50 / $139,398.85