630-4 — Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
Cite this view
HANK Price Transparency. (n.d.). NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE (CPT 630-4) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/630-4?code_type=CPT
“NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE (CPT 630-4) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/630-4?code_type=CPT. Accessed .
“NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE (CPT 630-4) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/630-4?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $156,990–$188,025 (25th–75th percentile) across 13 hospitals · 49 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT 630-4 — 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 |
|---|---|---|---|---|---|---|---|
| CROUSE HOSPITAL Inpatient | United Healthcare | Essential Plans 1 -4 | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Molina | Medicaid Hmo | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Wellcare | Medicaid Essential Plan 3 And 4 | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Brighton Healthplan | Medicaid | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Healthfirst Health Plan | Medicaid, Essential Plan 3&4, Medicaid Harp, And Child Health Plus | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Healthfirst Health Plan | Medicare Advantage And Medicaid Advantage Plus | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Excellus | Govt Programs/ Special Products | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Mvp | Commercial- Group | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | United Healthcare | Medicaid | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Fidelis | Medicaid Hmo | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Fidelis | Exchange Epp | $81,890.70 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Mycompass | Medicaid | $84,347.42 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Healthfirst Health Plan | Essential Plan 1 & 2 And Qualified Health Plans | $90,079.77 | — | — | 2026-05-09 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Inpatient | Blue Cross Blue Shield | Medicaid- Aca, Fhp, Icp | $93,578.97 | — | — | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Inpatient | Meridian | Medicaid | $96,386.34 | — | — | 2026-05-08 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Mvp | Commercial- Individual | $98,268.84 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Wellcare | Medicaid Essential Plan 1 And 2 | $98,268.84 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Fidelis | Exchange Qhp | $98,268.84 | — | — | 2026-05-09 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Upmc Chip | Upmc Chip | $149,766.67 | — | — | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | United Medicaid | United Medicaid | $149,766.67 | — | — | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | United Medicaid | United Medicaid | $149,766.67 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | United Chip | United Chip | $149,766.67 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Upmc Chip | Upmc Chip | $149,766.67 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | United Chip | United Chip | $149,766.67 | — | — | 2026-05-14 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | United Healthcare | Medicaid | $156,990.16 | — | — | 2026-05-06 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Anthem Blue Cross Blue Shield | Medicaid | $156,990.16 | — | — | 2026-05-23 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Anthem Blue Cross Blue Shield | Medicaid | $156,990.16 | — | — | 2026-05-14 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | United Healthcare | Medicaid | $156,990.16 | — | — | 2026-05-08 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | Molina | Medicaid | $156,990.16 | — | — | 2026-05-08 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | Anthem Blue Cross Blue Shield | Medicaid | $156,990.16 | — | — | 2026-05-06 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Amerihealth Caritas | Amerihealth Caritas Medicaid | $157,255.00 | — | — | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Amerihealth Caritas | Amerihealth Caritas Medicaid | $157,255.00 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Centene Corporation | Pa H And W Medicaid | $157,255.00 | — | — | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Centene Corporation | Pa H And W Medicaid | $157,255.00 | — | — | 2026-05-14 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | United Healthcare | Medicaid | $158,712.80 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Driscoll | Medicaid | $158,712.80 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Cigna | Medicaid | $158,712.80 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Cigna | Medicaid | $158,712.80 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Unitedhealthcare | Medicaid | $158,712.80 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Driscoll | Medicaid | $158,712.80 | — | — | 2026-05-08 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | Kaiser | Medicaid | $160,129.97 | — | — | 2026-05-08 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Kaiser | Medicaid | $160,129.97 | — | — | 2026-05-23 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Kaiser | Medicaid | $160,129.97 | — | — | 2026-05-14 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | Kaiser | Medicaid | $160,129.97 | — | — | 2026-05-06 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Blue Shield | Medicaid | $160,914.92 | — | — | 2026-05-23 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Blue Shield | Medicaid | $160,914.92 | — | — | 2026-05-14 | MRF ↗ |
| NORTHWEST HILLS SURGICAL HOSPITAL Inpatient | Molina | Medicaid | $161,794.61 | — | — | 2026-05-06 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Molina | Medicaid | $161,794.61 | — | — | 2026-05-08 | MRF ↗ |
| SOUTH TEXAS HEALTH SYSTEM Inpatient | Molina | Medicaid | $161,794.61 | — | — | 2026-05-08 | MRF ↗ |
| NORTHWEST HILLS SURGICAL HOSPITAL Inpatient | Amerigroup | Medicaid | $161,794.61 | — | — | 2026-05-06 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Upmc Health Plan | Upmc Medicaid | $162,856.28 | — | — | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Upmc Health Plan | Upmc Medicaid | $162,856.28 | — | — | 2026-05-23 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | Health Net | Medicaid | $164,211.71 | — | — | 2026-05-08 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | Health Net | Medicaid | $164,211.71 | — | — | 2026-05-06 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Geisinger Medicaid | Geisinger Medicaid | $164,743.34 | — | — | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Geisinger Medicaid | Geisinger Medicaid | $164,743.34 | — | — | 2026-05-23 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | Heritage | Medicaid | $166,409.57 | — | — | 2026-05-06 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | Heritage | Medicaid | $166,409.57 | — | — | 2026-05-08 | MRF ↗ |
| TEMECULA VALLEY HOSPITAL Inpatient | Iehp | Medicaid | $167,979.48 | — | — | 2026-05-08 | MRF ↗ |
| Southwest Healthcare System-wildomar Inpatient | Iehp | Medicaid | $167,979.48 | — | — | 2026-05-06 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Iehp | Medicaid | $167,979.48 | — | — | 2026-05-14 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Iehp | Medicaid | $167,979.48 | — | — | 2026-05-23 | MRF ↗ |
| NORTHWEST HILLS SURGICAL HOSPITAL Inpatient | First Care Star | Medicaid | $169,499.11 | — | — | 2026-05-06 | MRF ↗ |
| FAMILY HEALTH WEST HOSPITAL Inpatient | Rocky Mountain | Medicaid | $171,460.35 | — | — | 2026-05-18 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Medicaid Hmo Apr Eapg | Medicaid Hmo Apr Eapg | $179,071.67 | — | — | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Sunshine Medicaid | Sunshine Medicaid | $179,071.67 | — | — | 2026-05-22 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Clear Health Alliance | Clear Health Alliance | $179,071.67 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Molina Healthcare | Molina Healthcare Fl Kidcare | $179,071.67 | — | — | 2026-05-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Medicaid | Medicaid | $179,071.67 | — | — | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Medicaid Hmo Apr Drg | Medicaid Hmo Apr Drg | $179,071.67 | — | — | 2026-05-22 | 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 | Aetna Health | Aetna Better Health | $179,071.67 | — | — | 2026-05-22 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Mvp | Essential Plans 1-6 | $184,254.08 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Molina | Essential | $184,254.08 | — | — | 2026-05-09 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Fidelis | Essential Plans 1 -4 | $184,254.08 | — | — | 2026-05-09 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Sunshine Health Plan | Sunshine Health Plan Medicaid | $188,025.25 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Aetna Better Health Of Florida | Aetna Better Health Of Florida | $188,025.25 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $188,025.25 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Amerigroup | Simply Healthcare Plans | $188,025.25 | — | — | 2026-05-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Prestige Health Choice | Prestige Health Choice | $188,025.25 | — | — | 2026-05-22 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Amerigroup | Simply Healthcare Fl Healthy Kids | $188,025.25 | — | — | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | United Healthcare | United Healthcare Florida Healthy Kids | $188,025.25 | — | — | 2026-05-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Magellan Complete Care | Magellan Complete Care | $191,606.69 | — | — | 2026-05-22 | 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 | $195,063.44 | — | — | 2026-05-27 | MRF ↗ |
| OCHSNER MEDICAL CENTER - BATON ROUGE Inpatient | Molina Healthcare Of Mississippi - Managed Medicaid | All Plans | $195,063.44 | — | — | 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 ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Aetna Better Health Of Florida | Aetna Better Health Fl Healthy Kids | $196,978.84 | — | — | 2026-05-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Positive Healthcare | Positive Healthcare Medicaid | $196,978.84 | — | — | 2026-05-22 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Molina Healthcare | Molina Healthcare Of Fl Medicaid | $200,560.27 | — | — | 2026-05-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Simply Healthcare Plan | Simply Medicaid | $200,560.27 | — | — | 2026-05-22 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Cdphp | Commerical | $210,212.88 | — | — | 2026-05-09 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Lacare | Medicaid | $216,646.43 | — | — | 2026-05-23 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Inpatient | Lacare | Medicaid | $216,646.43 | — | — | 2026-05-14 | MRF ↗ |
| CROUSE HOSPITAL Inpatient | Mvp | Student | $223,322.90 | — | — | 2026-05-09 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Inpatient | Boston Medical Center /Wellsense- | Non-Metals (Baco) | $249,199.27 | — | — | 2026-05-08 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Inpatient | Mass Health | Medicaid | $249,199.27 | — | — | 2026-05-08 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Inpatient | Boston Medical Center /Wellsense | Silver | $299,039.12 | — | — | 2026-05-08 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Inpatient | Boston Medical Center /Wellsense - | All Other Metals | $473,478.61 | — | — | 2026-05-08 | MRF ↗ |