go back

Pennsylvania rates for MS-DRG 792

Prematurity Without Major Problems

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,668.00 / $37,463.00 / $54,112.60
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,809.34 / $21,809.34 / $26,112.08
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,765.00 / $8,192.64 / $41,787.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,599.68 / $32,736.01 / $51,639.68
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,708.00 / $4,708.00 / $4,708.00
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,865.56 / $14,162.82 / $36,387.26
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,825.00 / $37,428.69 / $53,786.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,216.88 / $32,008.59 / $51,063.37
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,621.40 / $18,927.30 / $27,228.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,850.00 / $27,480.02 / $52,390.84