602-4 — Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
Cite this view
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 ANOMALY (CPT 602-4) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/602-4?code_type=CPT
MLA (9th ed.)
“NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY (CPT 602-4) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/602-4?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY (CPT 602-4) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/602-4?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $91,072–$117,233 (25th–75th percentile) across 13 hospitals · 49 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT 602-4 — 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 |
|---|---|---|---|---|---|---|---|
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Inpatient | Blue Cross Blue Shield | Medicaid- Aca, Fhp, Icp | $60,271.59 | — | — | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Inpatient | Meridian | Medicaid | $62,079.74 | — | — | 2026-05-08 | MRF ↗ |
| ACMH HOSPITAL Inpatient | United Medicaid | United Medicaid | $76,750.27 | — | — | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | United Medicaid | United Medicaid | $76,750.27 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | United Chip | United Chip | $76,750.27 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Upmc Chip | Upmc Chip | $76,750.27 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | United Chip | United Chip | $76,750.27 | — | — | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Upmc Chip | Upmc Chip | $76,750.27 | — | — | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Amerihealth Caritas | Amerihealth Caritas Medicaid | $80,587.78 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Centene Corporation | Pa H And W Medicaid | $80,587.78 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Centene Corporation | Pa H And W Medicaid | $80,587.78 | — | — | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Amerihealth Caritas | Amerihealth Caritas Medicaid | $80,587.78 | — | — | 2026-05-14 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | United Healthcare | Medicaid | $82,490.14 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Driscoll | Medicaid | $82,490.14 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Cigna | Medicaid | $82,490.14 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Cigna | Medicaid | $82,490.14 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Unitedhealthcare | Medicaid | $82,490.14 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Driscoll | Medicaid | $82,490.14 | — | — | 2026-05-08 | MRF ↗ |
| NORTHWEST HILLS SURGICAL HOSPITAL Inpatient | Molina | Medicaid | $84,091.89 | — | — | 2026-05-06 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Molina | Medicaid | $84,091.89 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Molina | Medicaid | $84,091.89 | — | — | 2026-05-08 | MRF ↗ |
| NORTHWEST HILLS SURGICAL HOSPITAL Inpatient | Amerigroup | Medicaid | $84,091.89 | — | — | 2026-05-06 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Geisinger Medicaid | Geisinger Medicaid | $84,425.30 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Geisinger Medicaid | Geisinger Medicaid | $84,425.30 | — | — | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Upmc Health Plan | Upmc Medicaid | $85,084.99 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Upmc Health Plan | Upmc Medicaid | $85,084.99 | — | — | 2026-05-14 | MRF ↗ |
| NORTHWEST HILLS SURGICAL HOSPITAL Inpatient | First Care Star | Medicaid | $88,096.27 | — | — | 2026-05-06 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Medicaid Hmo Apr Drg | Medicaid Hmo Apr Drg | $100,000.00 | — | — | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Medicaid Hmo Apr Eapg | Medicaid Hmo Apr Eapg | $100,000.00 | — | — | 2026-05-22 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Molina Healthcare | Molina Healthcare Fl Kidcare | $100,000.00 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Clear Health Alliance | Clear Health Alliance | $100,000.00 | — | — | 2026-05-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | United Healthcare | United Behavioral Medicaid | — | — | — | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Medicaid | Medicaid | $100,000.00 | — | — | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Aetna Health | Aetna Better Health | $100,000.00 | — | — | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Sunshine Medicaid | Sunshine Medicaid | $100,000.00 | — | — | 2026-05-22 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Fidelis | Medicaid Hmo | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Wellcare | Medicaid Essential Plan 3 And 4 | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Fidelis | Exchange Epp | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Mvp | Commercial- Group | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Excellus | Govt Programs/ Special Products | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Healthfirst Health Plan | Medicare Advantage And Medicaid Advantage Plus | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Brighton Healthplan | Medicaid | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | United Healthcare | Essential Plans 1 -4 | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Molina | Medicaid Hmo | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | United Healthcare | Medicaid | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Healthfirst Health Plan | Medicaid, Essential Plan 3&4, Medicaid Harp, And Child Health Plus | $101,157.38 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Mycompass | Medicaid | $104,192.10 | — | — | 2026-05-09 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Amerigroup | Simply Healthcare Fl Healthy Kids | $105,000.00 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Sunshine Health Plan | Sunshine Health Plan Medicaid | $105,000.00 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Aetna Better Health Of Florida | Aetna Better Health Of Florida | $105,000.00 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Amerigroup | Simply Healthcare Plans | $105,000.00 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | United Healthcare | United Healthcare Florida Healthy Kids | $105,000.00 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $105,000.00 | — | — | 2026-05-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Prestige Health Choice | Prestige Health Choice | $105,000.00 | — | — | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Magellan Complete Care | Magellan Complete Care | $107,000.00 | — | — | 2026-05-22 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | Molina | Medicaid | $109,563.52 | — | — | 2026-05-08 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | Anthem Blue Cross Blue Shield | Medicaid | $109,563.52 | — | — | 2026-05-06 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | United Healthcare | Medicaid | $109,563.52 | — | — | 2026-05-06 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | United Healthcare | Medicaid | $109,563.52 | — | — | 2026-05-08 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Anthem Blue Cross Blue Shield | Medicaid | $109,563.52 | — | — | 2026-05-14 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Anthem Blue Cross Blue Shield | Medicaid | $109,563.52 | — | — | 2026-05-23 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Aetna Better Health Of Florida | Aetna Better Health Fl Healthy Kids | $110,000.00 | — | — | 2026-05-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Positive Healthcare | Positive Healthcare Medicaid | $110,000.00 | — | — | 2026-05-22 | MRF ↗ |
| FAMILY HEALTH WEST HOSPITAL Inpatient | Rocky Mountain | Medicaid | $110,432.50 | — | — | 2026-05-18 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Healthfirst Health Plan | Essential Plan 1 & 2 And Qualified Health Plans | $111,273.12 | — | — | 2026-05-09 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | Kaiser | Medicaid | $111,754.79 | — | — | 2026-05-06 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Kaiser | Medicaid | $111,754.79 | — | — | 2026-05-14 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Kaiser | Medicaid | $111,754.79 | — | — | 2026-05-23 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | Kaiser | Medicaid | $111,754.79 | — | — | 2026-05-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Simply Healthcare Plan | Simply Medicaid | $112,000.00 | — | — | 2026-05-22 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Molina Healthcare | Molina Healthcare Of Fl Medicaid | $112,000.00 | — | — | 2026-05-08 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Blue Shield | Medicaid | $112,302.61 | — | — | 2026-05-14 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Blue Shield | Medicaid | $112,302.61 | — | — | 2026-05-23 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | Health Net | Medicaid | $114,603.44 | — | — | 2026-05-08 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | Health Net | Medicaid | $114,603.44 | — | — | 2026-05-06 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | Heritage | Medicaid | $116,137.33 | — | — | 2026-05-06 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | Heritage | Medicaid | $116,137.33 | — | — | 2026-05-08 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Iehp | Medicaid | $117,232.96 | — | — | 2026-05-14 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | Iehp | Medicaid | $117,232.96 | — | — | 2026-05-06 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | Iehp | Medicaid | $117,232.96 | — | — | 2026-05-08 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Iehp | Medicaid | $117,232.96 | — | — | 2026-05-23 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Fidelis | Exchange Qhp | $121,388.85 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Mvp | Commercial- Individual | $121,388.85 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Wellcare | Medicaid Essential Plan 1 And 2 | $121,388.85 | — | — | 2026-05-09 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | United Healthcare Community Plan (Healthy Louisiana) | All Plans | — | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | Magnolia Health Plan - Mississippi Managed Medicaid | All Plans | $125,634.78 | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | Molina Healthcare Of Mississippi - Managed Medicaid | All Plans | $125,634.78 | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | Zelis | All Plans | — | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | Ochsner Health Plan | All Plans | — | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | Optum Va Ccn | All Plans | — | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | Peoples Health Network � Medicare Advantage | All Plans | — | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | Prime Health Services Ppo | All Plans | — | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | Usa Managed Care Network | All Plans | — | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | United Healthcare � Commercial Hmo Ppo | All Plans | — | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | United Healthcare � Commercial Select | All Plans | — | — | — | 2026-05-27 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Inpatient | Boston Medical Center /Wellsense- | Non-Metals (Baco) | $149,869.33 | — | — | 2026-05-08 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Inpatient | Mass Health | Medicaid | $149,869.33 | — | — | 2026-05-08 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Lacare | Medicaid | $151,197.66 | — | — | 2026-05-23 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Lacare | Medicaid | $151,197.66 | — | — | 2026-05-14 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Inpatient | Boston Medical Center /Wellsense | Silver | $179,843.20 | — | — | 2026-05-08 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Fidelis | Essential Plans 1 -4 | $227,604.10 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Mvp | Essential Plans 1-6 | $227,604.10 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Molina | Essential | $227,604.10 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Cdphp | Commerical | $259,925.18 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Mvp | Student | $276,135.54 | — | — | 2026-05-09 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Inpatient | Boston Medical Center /Wellsense - | All Other Metals | $284,751.73 | — | — | 2026-05-08 | MRF ↗ |