Neonatology reimbursement rates by service line
Compare payer-published neonatology benchmarks for normal newborn care; initial neonatal critical care; subsequent neonatal critical care; other neonatal services.
Compare national neonatology rates by payer
Use the reference codes to compare payer benchmarks, then explore normal newborn care; initial neonatal critical care; subsequent neonatal critical care; other neonatal services. Each rate represents a specific billing code and comparison cohort, rather than a complete episode of care.
Aetna state variation for 99460
National 99460 rate distribution
Each marker shows the national median published rate across billing entities for that payer.
National 99460 rates by payer
| Payer | Rate period | Provider entities | P25 | Median | P75 | P90 | Average |
|---|---|---|---|---|---|---|---|
| Aetna | Jun–Jul 2026 | 9,033 | $129.88 | $172.30 | |||
| Cigna | Jun–Jul 2026 | 9,656 | $182.86 | $220.37 | |||
| United | Jun–Jul 2026 | 9,372 | $172.66 | $191.84 | |||
| Anthem | Jun–Jul 2026 | 10,867 | $185.15 | $191.48 |
- Source
- Negotiated or fee-schedule amounts published directly by payers in their machine-readable files.
- Rate shown
- Published commercial rate for initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant (99460).
- Method
- Eligible rates are grouped by payer and billing entity so the benchmarks use a consistent service and billing basis.
The state map uses one consistent Aetna reference series; it does not average already-aggregated payer values. The service-line table keeps unlike codes, settings, and billing units in separate comparisons.
How do specific neonatology providers compare?
Compare named provider rates with the selected payer's median and percentile distribution.
National: Neonatology provider benchmarks (CPT 99460)
| Provider entity | State | Size | $ per service | Gap to median | Position in Aetna range |
|---|---|---|---|---|---|
| CHILDRENS HOSPITAL OF ORANGE COUNTYNPI 1619920816 · Tax ID 952321786 | CA | 1,084 | $52.71 | -$77.18 | Below P25 |
| DISTRICT MEDICAL GROUP INCNPI 1063823078 · Tax ID 208106540 | PA | 1,908 | $72.76 | -$57.12 | Below P25 |
| STAMFORD HEALTH MEDICAL GROUP INCNPI 1154633980 · Tax ID 271648289 | CT | 828 | $82.69 | -$47.19 | Below P25 |
| JORDAN PHYSICIAN ASSOCIATES INCNPI 1396854311 · Tax ID 043228556 | RI | 3,335 | $95.46 | -$34.42 | P25 to median |
| ASSOCIATED PHYSICIANS OF HARVARD FACULTY PHYSICIANS AT BETH ISREALNPI 1235218843 · Tax ID 320058309 | MA | 4,968 | $122.67 | -$7.21 | P25 to median |
| PEDIATRIX OF MARYLAND PANPI 1013953579 · Tax ID 650859857 | MD | 274 | Above P75 |
Choose one state to replace the mixed-state examples with payer-specific provider rates across all three preview codes.
No trial or data preparation required.Explore neonatology services
Compare codes within the same billing context. A reported billing unit may describe a timed service, supply quantity, daily service or procedure; it does not always mean one visit.
| Service line / billing code | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|
$ per reported billing unit · 12 codes | ||||
99460Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant | $172.30 | $220.37 | $191.84 | $191.48 |
99462Newborn Exam And Care | $77.41 | $97.86 | $85.29 | $91.22 |
99463Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date | $187.44 | $257.82 | $225.85 | $234.12 |
99464Birthing Specialist Attendant | $151.04 | $190.31 | $154.33 | $189.79 |
99465Delivery or birthing room attendance and newborn stabilization | $285.11 | $365.99 | $304.70 | $369.36 |
99468Initial inpatient neonatal critical care, per day, for evaluation and management of critically ill neonate, 28 days of age or younger | $1,546.35 | $2,272.23 | $1,905.26 | $2,054.82 |
99469Subsequent inpatient neonatal critical care, per day, for evaluation and management of critically ill neonate, 28 days of age or younger | $698.50 | $1,034.19 | $825.60 | $916.21 |
99472Subsequent inpatient pediatric critical care, age 2 through 5 years | $721.74 | $1,041.47 | $841.06 | $907.03 |
99477Initial hospital care of neonate, 28 days or younger, requiring intensive observation | $607.21 | $884.43 | $724.47 | $797.96 |
99478Subsequent intensive care for low-birth-weight infant, 1,500 to 2,500 grams | $264.84 | $368.25 | $286.97 | $321.27 |
99479Subsequent intensive care for low-birth-weight infant, 1,000 to 1,500 grams | $237.62 | $339.11 | $261.95 | $287.29 |
99480Medical Care | $211.98 | $324.33 | $250.64 | $304.97 |
$ per reported billing unit · 6 codes | ||||
92650Test Of Hearing And Nerves | $56.46 | $81.12 | $67.78 | $64.96 |
92651Test Of Hearing And Nerves | $139.50 | $221.53 | $201.19 | $203.15 |
54150Newborn circumcision using clamp or other device | $257.61 | $351.69 | $374.86 | $344.98 |
V5008Hearing screening | $36.35 | $35.14 | $88.41 | $67.40 |
94780Car seat or bed testing for airway integrity, infant 12 months or younger, initial 60 minutes | $77.30 | $105.84 | $115.41 | $99.86 |
94781Car seat or bed testing for airway integrity, infant 12 months or younger, each additional 30 minutes | $28.56 | $40.35 | $45.49 | $37.96 |
$ per reported billing unit · 1 code | ||||
T2101Human breast milk processing | $7.90 | $5.80 | Not available | Not available |
$ per reported billing unit · 1 code | ||||
99252Inpatient or observation consultation, level 2 | $136.87 | $172.22 | $159.80 | $165.51 |
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Book a 20-min scoping call No trial or data preparation required.How to interpret these benchmarks
Payer-published rates provide market context. They do not establish a practice's contracted rate or the total cost of care.
- Source and periodRates come from the specialty's national report. The displayed period follows the processed data included in the latest published snapshot and updates when that snapshot is refreshed.
- Comparable ratesComparisons use positive professional fee-for-service negotiated and fee-schedule dollar amounts. Percentages, bundled arrangements and per-diem rate types are excluded. Modifier cohorts and code-specific amounts remain separate.
- CalculationRates are reduced to one modal value per NPI and TIN entity, averaging tied modes. Two percent per tail is targeted for trimming while keeping boundary ties. Benchmarks require at least 10 included entities and are not weighted by patient volume.
- CoverageNational report coverage does not guarantee every payer or state is available for every code. Anthem represents the displayed Anthem cohort, rather than all regional Blue plans. Missing benchmarks are not zero rates.
- Billing contextMatch the exact code, billing unit, modifier, setting and network. Equipment rentals and supplies require their own interval and quantity checks. Professional rates exclude facility charges; anesthesia conversion factors are outside these comparisons.
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Explore neonatology rates by state
Choose a state to compare payer reference averages for common services.
Questions about neonatology benchmarks
How to interpret the selected market and payer-published rates.
What does the national benchmark compare?
The headline uses Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant (99460). The other reference codes and service lines provide separate comparisons rather than combining unlike services.
Why is a payer or state missing?
A benchmark appears only when the selected code and cohort meet the publication rules, including at least 10 entities after trimming. Report-wide coverage can be broader than an individual comparison.
Will the reporting period change?
Yes. The period displayed with the benchmark follows the processed source data when the publication snapshot is refreshed.