602 SOI-4 — Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major An
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APA (7th ed.)
HANK Price Transparency. (n.d.). NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR AN (OTHER 602 SOI-4) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/602 SOI-4?code_type=OTHER
MLA (9th ed.)
“NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR AN (OTHER 602 SOI-4) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/602 SOI-4?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR AN (OTHER 602 SOI-4) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/602 SOI-4?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $172,873–$184,773 (25th–75th percentile) across 5 hospitals · 7 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 602 SOI-4 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| INOVA FAIR OAKS HOSPITAL Inpatient | Anthem | Medicaid Advantage | $164,926.76 | — | — | 2026-05-14 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Anthem | Medicaid Advantage | $164,926.76 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Humana | Medicaid Advantage | $164,926.76 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Humana | Medicaid Advantage | $164,926.76 | — | — | 2026-05-14 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Anthem | Medicaid Advantage | $167,306.90 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Humana | Medicaid Advantage | $167,306.90 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | United | Medicaid Advantage | $168,225.30 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | United | Medicaid Advantage | $168,225.30 | — | — | 2026-05-14 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Anthem | Medicaid Advantage | $168,614.93 | — | — | 2026-07-15 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Anthem | Medicaid Advantage | $168,822.91 | — | — | 2026-07-15 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Humana | Medicaid Advantage | $168,822.91 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Anthem | Medicaid Advantage | $169,483.67 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Anthem | Medicaid Advantage | $169,483.67 | — | — | 2026-05-14 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $169,874.56 | — | — | 2026-05-14 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $169,874.56 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | United | Medicaid Advantage | $170,653.04 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Anthem | Medicaid Advantage | $170,984.22 | — | — | 2026-07-15 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | United | Medicaid Advantage | $171,987.23 | — | — | 2026-07-15 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Anthem | Medicaid Advantage | $172,052.01 | — | — | 2026-08-01 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Humana | Medicaid Advantage | $172,052.01 | — | — | 2026-08-01 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | United | Medicaid Advantage | $172,199.37 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $172,326.10 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | United | Medicaid Advantage | $172,873.34 | — | — | 2026-05-14 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | United | Medicaid Advantage | $172,873.34 | — | — | 2026-05-22 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $173,673.37 | — | — | 2026-07-15 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $173,887.59 | — | — | 2026-07-15 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Anthem | Medicaid Advantage | $174,128.94 | — | — | 2026-05-13 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Anthem | Medicaid Advantage | $174,128.94 | — | — | 2026-05-22 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Humana | Medicaid Advantage | $174,128.94 | — | — | 2026-05-13 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Humana | Medicaid Advantage | $174,128.94 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | United | Medicaid Advantage | $174,403.91 | — | — | 2026-07-15 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Anthem | Medicaid Advantage | $174,459.19 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $174,568.18 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $174,568.18 | — | — | 2026-05-14 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Humana | Medicaid Advantage | $175,359.52 | — | — | 2026-07-15 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | United | Medicaid Advantage | $175,493.05 | — | — | 2026-08-01 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $176,113.75 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Humana | Medicaid Advantage | $176,263.02 | — | — | 2026-05-14 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Humana | Medicaid Advantage | $176,263.02 | — | — | 2026-05-22 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Aetna | Medicaid Advantage | $177,045.67 | — | — | 2026-07-15 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $177,213.57 | — | — | 2026-08-01 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | United | Medicaid Advantage | $177,611.52 | — | — | 2026-05-13 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | United | Medicaid Advantage | $177,611.52 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Humana | Medicaid Advantage | $177,823.59 | — | — | 2026-07-15 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | United | Medicaid Advantage | $177,948.37 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Aetna | Medicaid Advantage | $177,957.85 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Aetna | Medicaid Advantage | $177,957.85 | — | — | 2026-05-14 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Anthem | Medicaid Advantage | $178,708.13 | — | — | 2026-05-22 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Anthem | Medicaid Advantage | $178,708.13 | — | — | 2026-05-14 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $179,352.81 | — | — | 2026-05-22 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $179,352.81 | — | — | 2026-05-13 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Aetna | Medicaid Advantage | $179,533.43 | — | — | 2026-07-15 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $179,692.97 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Aetna | Medicaid Advantage | $181,419.44 | — | — | 2026-05-14 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Magellan Healthcare | Medicaid Advantage | $181,419.44 | — | — | 2026-05-14 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Aetna | Medicaid Advantage | $181,419.44 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $181,419.44 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Magellan Healthcare | Medicaid Advantage | $181,419.44 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $181,419.44 | — | — | 2026-05-14 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Humana | Medicaid Advantage | $181,437.56 | — | — | 2026-07-15 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | United | Medicaid Advantage | $182,282.29 | — | — | 2026-05-14 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | United | Medicaid Advantage | $182,282.29 | — | — | 2026-05-22 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Aetna | Medicaid Advantage | $183,182.15 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Magellan Healthcare | Medicaid Advantage | $184,037.59 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Aetna | Medicaid Advantage | $184,037.59 | — | — | 2026-07-15 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $184,037.59 | — | — | 2026-07-15 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $184,069.37 | — | — | 2026-05-22 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Sentara Health | Medicaid Advantage | $184,069.37 | — | — | 2026-05-14 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $185,476.42 | — | — | 2026-07-15 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Magellan Healthcare | Medicaid Advantage | $185,705.20 | — | — | 2026-07-15 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Aetna | Medicaid Advantage | $185,705.20 | — | — | 2026-07-15 | MRF ↗ |
| INOVA ALEXANDRIA HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $185,705.20 | — | — | 2026-07-15 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Humana | Medicaid Advantage | $185,856.45 | — | — | 2026-05-22 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Humana | Medicaid Advantage | $185,856.45 | — | — | 2026-05-14 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $186,432.04 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIR OAKS HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $186,432.04 | — | — | 2026-05-14 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Aetna | Medicaid Advantage | $187,643.54 | — | — | 2026-05-14 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Aetna | Medicaid Advantage | $187,643.54 | — | — | 2026-05-22 | MRF ↗ |
| INOVA FAIRFAX HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $188,082.65 | — | — | 2026-07-15 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Magellan Healthcare | Medicaid Advantage | $189,257.21 | — | — | 2026-08-01 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Aetna | Medicaid Advantage | $189,257.21 | — | — | 2026-08-01 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $189,257.21 | — | — | 2026-08-01 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $191,541.84 | — | — | 2026-05-22 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Aetna | Medicaid Advantage | $191,541.84 | — | — | 2026-05-22 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $191,541.84 | — | — | 2026-05-13 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Aetna | Medicaid Advantage | $191,541.84 | — | — | 2026-05-13 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Magellan Healthcare | Medicaid Advantage | $191,541.84 | — | — | 2026-05-22 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Magellan Healthcare | Medicaid Advantage | $191,541.84 | — | — | 2026-05-13 | MRF ↗ |
| INOVA MOUNT VERNON HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $191,905.11 | — | — | 2026-07-15 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $196,578.94 | — | — | 2026-05-22 | MRF ↗ |
| INOVA LOUDOUN HOSPITAL Inpatient | Kaiser | Medicaid Advantage | $196,578.94 | — | — | 2026-05-14 | MRF ↗ |