go back

Washington rates for MS-DRG 792

Prematurity Without Major Problems

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,257.00 / $59,845.70 / $101,448.00
Ambetter
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,744.80 / $19,744.80 / $19,744.80
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,100.00 / $35,394.71 / $63,614.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.00 / $44,253.98 / $73,539.02
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,200.00 / $34,615.00 / $51,422.80
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,600.00 / $31,156.68 / $50,818.65
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,300.00 / $42,212.99 / $63,951.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $16,201.46 / $64,627.04